Integrated Molecular and Histopathological Evaluation of Survivin and VEGF in Hepatocellular Carcinoma

Background: Survivin and vascular endothelial growth factor (VEGF) are key regulators of apoptosis inhibition and tumor angiogenesis, respectively, and play critical roles in the progression of hepatocellular carcinoma (HCC). This study aimed to evaluate the expression of survivin and VEGF in HCC tissues and to investigate their association with clinicopathological features. Methods: A total of 30 patients with HCC were included. Tumor and adjacent non-neoplastic liver tissues were collected during surgical resection. Survivin and VEGF mRNA expression levels were analyzed using reverse transcriptase polymerase chain reaction (RT-PCR). Serum samples were assessed for hepatitis B and C virus infection using ELISA and PCR. Histopathological and histochemical examinations were performed to evaluate structural changes across tumor grades. Statistical analyses were conducted to assess associations between molecular markers and clinical parameters. Results: Survivin expression was detected in 73.3% of HCC tissues compared with 36.7% of adjacent tissues, while VEGF expression was observed in 43.3% and 40.0%, respectively. Among survivin-positive tumor samples, 59% co-expressed VEGF, demonstrating a significant association (p < 0.05). No significant correlations were found between survivin or VEGF expression and patient age, sex, or hepatitis B/C infection status. Histopathological analysis revealed progressive morphological alterations with increasing tumor grade, including cellular pleomorphism, increased mitotic activity, fibrosis, and nodular tumor formation. Conclusions: The findings indicate that survivin overexpression contributes to impaired apoptosis regulation, while VEGF promotes angiogenesis in HCC. Their co-expression suggests a functional interplay that may enhance tumor progression. Survivin, particularly in combination with VEGF, may serve as a valuable diagnostic and prognostic biomarker and represents a potential therapeutic target in hepatocellular carcinoma.