Morphologic classification of microvessels in hepatocellular carcinoma is associated with the prognosis after resection

Background and Aim: The relationship between neovasculature in hepatocellular carcinoma (HCC) and the prognosis of patients still remains controversial. The aim of the present study was to investigate the prognostic significance of morphologic features of the microvessels in patients with HCC after resection. Methods: The paraffin-embedding specimens of 98 consecutive HCC patients, who received primary resection between 2000 and 2002, were collected from our prospective established tumor bank. The intratumoral microvessels were evaluated by immunohistochemical staining for CD31 and CD34. The disease-free survival (DFS) and overall survival (OS) of patients were analyzed by Kaplan-Meier analysis and Cox proportional hazards regression model. Results: There are two distinct microvessel types: capillary-like and sinusoid-like were identified in tumor tissues. The patients could be divided into two groups according to their microvessel types. Both DFS and OS of capillary group patients (n = 65) were better than those of sinusoid group patients (n = 33). Multivariate analyses showed that the microvessel type was an independent risk factor for DFS (P = 0.016) and OS (P = 0.004) of this cohort. Capillary-like microvessels were more common in small HCC, and were significantly associated with higher microvessel density, while sinusoid-like microvessels were significantly correlated with lower microvessel density. Conclusions: The results of our study suggested that the microvessel type is an effective predictor of survival in patients with HCC after resection, which might serve as potential novel therapeutic targets for prevention of the recurrence of HCC after resection.