Prognostic significance and mechanisms of patterned matrix vasculogenic mimicry in hepatocellular carcinoma

Vasculogenic mimicry (VM), including tubular VM and patterned matrix VM, has been generally recognized as a new pattern of tumor neovascularization. Pilot studies of tubular VM showed that it was present in hepatocellular carcinoma (HCC) and associated with poor clinical prognosis. However, whether patterned matrix VM is clinically significant in HCC is unknown. To elucidate the effects of patterned matrix VM on prognosis of HCC and the mechanisms involved in VM formation, we examined 151 cases of surgically resected human HCC by immunohistochemistry and transmission electron microscopy and conducted hypoxic experiments on human HCC cell line MHCC97-H. We observed 31 of 151 (20.5%) cases exhibited evidence of patterned matrix VM. The expression of patterned matrix VM was associated with larger tumors ( P = 0.042), vascular invasion ( P = 0.016), high-grade HCC ( P = 0.022), and late-stage HCC ( P = 0.013). Kaplan–Meier survival analysis revealed that cases of the VM group had lower overall survival (OS) rate ( P