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Carvalho SCR. Polymorphisms in the vascular endothelial growth factor (VEGF) and methylenetetrahydrofolate reductase (MTHFR) gene in patients with hepatocellular carcinoma and hepatitis C virus infection [thesis]. São Paulo: “Faculdade de Medicina, Universidade de São Paulo”; 2018. BACKGROUND: Hepatic cirrhosis is a risk factor for hepatocellular carcinoma (HCC) and in Brazil, the most frequent chronic liver disease associated with HCC is chronic hepatitis C virus (HCV) infection. Angiogenesis and folate deficiency may be associated with the risk of HCC. Thus, gene polymorphisms related to such processes VEGF and MTHFR in patients with chronic hepatitis C and HCC may lead to genetic markers for HCC in HCV infection. OBJECTIVES: To evaluate the polymorphisms G634C (rs2010963), C460T (rs833061), C936T (rs3025039) of the VEGF gene and polymorphisms C677T (rs1801133) and C1298A (1801131) of MTHFR, in Brazilian patients with HCC and chronic HCV infection. PATIENTS AND METHODS: A total of 119 patients with HCC and HCV follow-up were included in the HUOC / UPE and IFP-PE hepatology clinic in Brazil. This study was approved by the ethics committee and the patients signed the consent form. All patients had a diagnosis of HCV by PCR and HCC by magnetic resonance and / or tomography. RESULTS: Among the individuals with HCC, 70.59% were men. The mean age of participants was 62.3 years. According to the Child-Pugh classification, the following were distributed: At 60.9%; B 36.5%; C 2.6%. The mean tumor size was 4.4 cm. Being that 52.10% was multinodular. An association analysis was made with the MTHFR and VEGF genes and tumor characteristics in HCC patients chronically infected with HCV. The C alleles of MTHFR (rs1801131) and VEGF (rs2010963) were associated with developmental protection of the multinodular form, and the MTHFR T allele (rs1801133) was associated with a risk factor for development of the multinodular form p = 0, 04 OR 1,835 IC (1,0223,297). Multivariate analyzes, including male gender and age as potential confounders, were performed in the VEGF gene genotype CC (rs2010963), which was an independent factor associated with the protection of the development of multinodular tumors. A survival analysis stratified by the MTHFR (rs1801131), MTHFR (rs1801133) and VEGF (rs2010963) genotypes was also performed, but no significant results were observed. CONCLUSIONS: It was observed that the MTHFR and VEGF genes have influence on the uni or multinodular presentation of the tumor. Descriptors: carcinoma, hepatocellulr; vascular endothelial growth factor A; polymorphism, genetic; hepatitis C; liver; liver cirrhosis.

Avaliação de polimorfismos no gene do fator de crescimento endotelial vascular (VEGF) e da metilenotetrahidrofolato redutase (MTHFR) em pacientes com carcinoma hepatocelular e infecção pelo vírus da hepatite C