malignant tumor type, including HCC, as tumors must recruit vessels to ..... Boettiger D, et al: Tensional homeostasis and the malignant phenotype. Cancer Cell ...
ONCOLOGY LETTERS
The heterogenic tumor microenvironment of hepatocellular carcinoma and prognostic analysis based on tumor neo‑vessels, macrophages and α‑SMA MIN FANG1*, JINGPING YUAN2*, MENGYUAN CHEN3, ZONGWEN SUN4, LULU LIU3, GUOPING CHENG5, HANGJIE YING1, SHIFENG YANG5 and MING CHEN1 1
Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang Key Laboratory of Radiation Oncology & College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, Zhejiang 310022; 2Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; 3 Department of Oncology, The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053; 4Department of Oncology, Jining No. 1 People's Hospital, Jining, Shandong 272011; 5Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China Received July 25, 2017; Accepted December 4, 2017 DOI: 10.3892/ol.2018.7946 Abstract. The present study was performed to quantify tumor neo‑vessels, macrophages and fibroblasts in the tumor micro‑ environment of hepatocellular carcinoma (HCC) and explore the prognostic factors of HCC. The distribution of tumor neo‑vessels, macrophages and fibroblasts was quantified by immunohistochemistry and inverted microscopy with the CRi Nuance multispectral imaging system, and the correlation of these parameters with the clinico‑pathological characteristics and overall survival of the patients was analyzed. The number of tumor neo‑vessels and macrophages, and density of the fibro‑ blasts, as calculated by the thickness of the tumor stroma in the tumor microenvironment, ranged from 51‑429 (median, 218), 110‑555 (median, 259) and 35.6‑555.5 µm (median, 247.0), respectively. Using the median values as a cutoff, the cases were stratified into high‑ and low‑density groups. Survival analysis demonstrated that the high‑density groups regarding macrophages (χ2=5.249, P=0.022) and fibroblasts (χ2=18.073, P40% of global HCC‑associated deaths (2). Despite recent advances in the diagnosis and treatment of HCC, it remains a highly lethal disease and the survival of most patients remains poor with no significant reduction in the mortality rate over the past decades. Even following radical resection of small HCC (tumor sizes
