Serum vascular endothelial growth factor as a tumor marker for hepatocellular carcinoma in hepatitis C virus-related cirrhotic patients

Table 1 Demographic and clinical characteristics of the three study groups

		HCC group	Cirrhosis group	Control group	P value
Gender	Male	30	17	20	> 0.05
	Female	10	13	10
Age (years)	mean (SD)	60.07 ± 5.34	58.33 ± 8.07	55.2 ± 7.6	> 0.05
	Range	50-68	37-67	34-62
Child-Pugh score, n (%)	A	24 (60.0)	19 (63.3)	Not applicable
	B	11 (27.5)	8 (26.7)	Not applicable
	C	5 (12.5)	3 (10.0)	Not applicable

HCC: Hepatocellular carcinoma; SD: Standard deviation.

Table 2 Biomarker levels in the three study groups

	HCC group			Cirrhosis group			Control group			P value
	Mean	SD	Median	Mean	SD	Median	Mean	SD	Median
AFP (ng/mL)	694.6	885.38	169.5	29.71	38.71	12.95	23.58	32.15	9.5	< 0.0011
VEGF (pg/mL)	1409	917.40	1250	233.3	196.51	150	204	190.89	110	< 0.0011
VEGF/PLT	13.2	10.42	10.64	1.68	1.40	1.18	0.95	0.71	0.72	< 0.0011

¹Kruskal Wallis test.

AFP: Alpha fetoprotein; VEGF: Vascular endothelial growth factor; PLT: Platelet; SD: Standard deviation; HCC: Hepatic cell carcinoma.

Table 3 Diagnostic performance of alpha fetoprotein, vascular endothelial growth factor, and vascular endothelial growth factor/platelet, separately and in combination, in the prediction of hepatocellular carcinoma

	Cut-off point	AUC	Sensitivity	Specificity	Accuracy	PPV	NPV	P value
AFP	40	0.754	65.00	83.33	74.17%	72.2	78.1	< 0.0001
VEGF	250	0.859	80.00	81.67	80.84	74.4	86.0	< 0.0001
VEGF/PLT	2.31	0.842	77.50	80.00	78.75	72.1	84.2	< 0.0001
Combination	--	0.953	92.50	98.33	95.42	97.4	95.2	< 0.0001

AUC: Area under the receiver operating characteristic curve; PPV: Positive predictive value; NPV: Negative predictive value; AFP: Alpha fetoprotein; VEGF: Vascular endothelial growth factor; PLT: Platelet.

Table 4 Correlations between tumor characteristics (tumor size and stage) and each of alpha fetoprotein, vascular endothelial growth factor and vascular endothelial growth factor/ platelet among hepatocellular carcinoma cases

		AFP (ng/mL)	VEGF (pg/mL)	VEGF/PLT
Size of tumor	Correlation coefficient	0.492	0.662	0.483
	P value	0.001	0.0001	0.002
TNM stage of tumor	Correlation coefficient	0.247	0.795	0.696
	P value	0.124	0.0001	0.0001
BCLC stage of tumor	Correlation coefficient	0.382	0.889	0.740
	P value	0.015	0.0001	0.0001

AFP: Alpha fetoprotein; VEGF: Vascular endothelial growth factor; PLT: Platelet; BCLC: Barcelona clinic liver; TNM: Tumor/node/metastasis.

Table 5 Correlations between the presence of portal vein thrombosis and each of serum alpha fetoprotein, vascular endothelial growth factor, and vascular endothelial growth factor/platelet levels among hepatocellular carcinoma cases

	No PVT		PVT		Independent t-test
	Mean	SD	Mean	SD	t-value	P value
AFP (ng/mL)	580.64	854.69	1143.63	923.42	−1.641	0.109
VEGF (pg/mL)	1231.56	907.97	2056.25	661.94	−2.404	0.021
VEGF/PLT	11.35	9.98	20.85	9.12	−2.446	0.019

AFP: Alpha fetoprotein; VEGF: Vascular endothelial growth factor; PLT: Platelet; PVT: Portal vein thrombosis; SD: Standard deviation.

Table 6 Correlation between serum vascular endothelial growth factor and platelet count among the three study groups

	VEGF
	HCC group		CLC group		Control group
	r	P value	r	P value	r	P value
Platelets	0.6681	0.002	-0.0071	0.970	0.0531	0.781

¹Spearman correlation coefficients.

VEGF: Vascular endothelial growth factor; CLC: Hepatitis C virus-related liver cirrhosis; HCC: Heptatocellular carcinoma.

Table 7 Correlation between serum alpha fetoprotein and vascular endothelial growth factor levels among hepatocellular carcinoma cases

	AFP (ng/mL)
	r	P value
VEGF (pg/mL)	0.119	0.4631

¹Spearman correlation coefficients.

AFP: Alpha fetoprotein; VEGF: Vascular endothelial growth factor.

Table 8 Correlation between serum alpha fetoprotein and vascular endothelial growth factor/platelet levels among hepatocellular carcinoma cases

	AFP (ng/mL)
	r	P value
VEGF/PLT	0.175	0.2801

¹Spearman correlation coefficients.

AFP: Alpha fetoprotein; VEGF/PLT: Vascular endothelial growth factor/platelet.

Table 9 Positive correlation between serum vascular endothelial growth factor; and vascular endothelial growth factor/platelet levels among hepatocellular carcinoma cases

	VEGF (pg/mL)
	r	P value
VEGF/PLT	0.925	0.0001

¹Spearman correlation coefficients.

VEGF: Vascular endothelial growth factor; PLT: Platelet.