Microvessel Density (MVD) Quantitation With Image Analysis in Patients With Viral Hepatitis Versus Nonviral Hepatitis-Related Hepatocellular Carcinoma: 587

Introduction: To compare MVD and overall survival in 2 different groups of hepatocellular carcinoma (HCC), namely viral hepatitis-related HCC (Hr-HCC) versus nonviral-hepatitis related HCC (NHr-HCC). Methods: Seventy-eight consecutive cases of HCC (47 hepatitis and 31 non-hepatitis cases) were studied. Microvessel numbers were assessed by staining for the antigens CD31, 34, and CD240. The highest number of MVD and number of vessels were counted in the tumor, and the mean value represented the final MVD. Overall survival (OS) was analyzed between the 2 groups.Table 1: Mean Number of Vessels and MVD in HCCFigure 1: (A) HCC tissue microarray stained with CD31 immunohistochemistry. (B) Markup image generated by the MVD algorithm highlighting the microvessels counted in green. (C) HCC tissue microarray stained with CD34 immunohistochemistry. (D) Markup image generated by the MVD algorithm highlighting the microvessels counted in green.Results: Hr-HCC and NHr-HCC were observed in 47 and 31 cases, respectively. No significant differences were seen between the Hr-HCC and NHr-HCC groups with respect to age, gender or Childs-Pugh class distribution. Mean number of vessels was significantly higher in Hr-HCC using CD31 (97.7 vs 83.7), and CD34 (82.4 vs 71.9), (p-value 0.025 and 0.039, respectively). Higher MVD was detected in Hr-HCC compared to NHr-HCC using CD31 (4.9 vs 4.4), and CD34 (4.7 vs 4.3), (p-value 0.0095 and 0.0190, respectively). No significant difference was observed between Hr-HCC and NHr-HCC using CD240 immunostaining fro MVD (p-value 0.0945 and 0.906, respectively). There was no statistically significant difference in overall survival between Hr-HCC and NHr-HCC groups (p-value 0.104). Conclusion: HCC due to hepatitis has higher tumor microsatellite formation and higher MVD values. This observation may explain the higher response of agents that target vascular endothelial growth factor (like sorafenib) in patients with Hr-HCC.