Vessels that encapsulate tumour clusters vascular pattern in hepatocellular carcinoma

Ken Liu; Claude Dennis; David S Prince; Felix Marsh-Wakefield; Cositha Santhakumar; Jennifer R Gamble; Simone I Strasser; Geoffrey W McCaughan

doi:10.1016/j.jhepr.2023.100792

Vessels that encapsulate tumour clusters vascular pattern in hepatocellular carcinoma

JHEP Rep. 2023 May 11;5(8):100792. doi: 10.1016/j.jhepr.2023.100792. eCollection 2023 Aug.

Authors

Ken Liu^{1

2

3}, Claude Dennis¹, David S Prince⁴, Felix Marsh-Wakefield^{3

5}, Cositha Santhakumar^{1

3

5}, Jennifer R Gamble⁶, Simone I Strasser^{1

2}, Geoffrey W McCaughan^{1

2

3}

Affiliations

¹ Australian National Liver Transplant Unit, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
² Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
³ Liver Injury and Cancer Program, Centenary Institute, Sydney, NSW, Australia.
⁴ Department of Gastroenterology, Liverpool Hospital, Sydney, NSW, Australia.
⁵ Human Immunology Laboratory, The University of Sydney, Sydney, NSW, Australia.
⁶ Centre for Endothelium, Vascular Biology Program, Centenary Institute, Sydney, NSW, Australia.

Abstract

Vessels that encapsulate tumour clusters (VETC) is a distinct histologic vascular pattern associated with a novel mechanism of metastasis. First described in human cancers in 2004, its prevalence and prognostic significance in hepatocellular carcinoma (HCC) has only been appreciated in the past decade with a rapidly increasing body of literature. A robust biomarker of aggressive disease, the VETC pattern is easy to recognise but relies on histologic examination of tumour tissue for its diagnosis. Radiological recognition of the VETC pattern is an area of active research and is becoming increasingly accurate. As a prognostic marker, VETC has consistently proven to be an independent predictor of disease recurrence and overall survival in patients with HCC undergoing resection and liver transplantation. It can also guide treatment by predicting response to other therapies such as transarterial chemoembolisation and sorafenib. Without prospective randomised-controlled trials or routine evaluation of VETC in clinical practice, there are currently no firm treatment recommendations for VETC-positive tumours, although some perspectives are provided in this review based on the latest knowledge of their pathogenesis - a complex interplay between tumour angiogenesis and the immune microenvironment. Nevertheless, VETC has great potential as a future biomarker that could take us one step closer to precision medicine for HCC.

Keywords: Vessels that encapsulate tumour clusters (VETC); angiogenesis; biomarker; epithelial mesenchymal transition (EMT); liver transplantation; metastasis.

Publication types

Review