For instance, an in vitro study mimicking the augmented TME polyamine levels in HCC showed a subsequent increase in the levels of Akt1 along with those of ornithine decarboxylase, spermidine/spermine N1 acetyl transferase, hypoxia inducing factor 1α, matrix metalloproteinase 9, VEGF, and downregulated p27. Here, VEGFA is linked to hepatocellular carcinoma.