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High expression of vascular endothelial growth factor predicts early recurrence and poor prognosis after curative resection for ductal adenocarcinoma of the pancreas.
- Source :
-
Pancreas [Pancreas] 2002 Aug; Vol. 25 (2), pp. 122-9. - Publication Year :
- 2002
-
Abstract
- Introduction and Aims: Only curative resection for pancreatic adenocarcinoma is related to a favorable prognosis, but the overall survival after surgery still remains poor, and early recurrence is frequently observed. Because recurrence is the limiting factor and the main cause of death after curative resection, the identification of markers that predict early postoperative recurrence is of paramount importance. Angiogenesis is essential for tumor growth and metastases; therefore, we set out to clarify whether vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) correlate with early recurrence and poor prognosis after curative resection. A second goal was to characterize the VEGF-producing cells and the subcellular distribution.<br />Methodology: Seventy patients with ductal adenocarcinoma of the pancreas were studied after curative resection with a follow-up of at least 2 years. The MVD quantification was performed immunohistochemically with use of a monoclonal antibody to CD34. The VEGF expression was studied with use of polyclonal antibody. To detect the intracellular localization of specific VEGF mRNA sequences, nonisotopic in situ hybridization was performed. The correlations among VEGF expression and MVD, clinicopathologic parameters, and clinical outcome were then statistically analyzed.<br />Results: The VEGF immunoreactivity was 88.6%, and positive mRNA signals were obtained in the cytoplasm of carcinoma and endothelial cells in 81.4%. Furthermore, we observed tumor-associated macrophages close to infiltrating carcinoma cells. All endothelial cells showed positive immunoreactivity to the anti-CD34 antibody, and a median distribution of 85 vessels/x200 field was observed. A significant correlation (p < 0.05) was found between the MVD and the International Union Against Cancer (UICC) stage. Statistical analysis showed a significant correlation between VEGF expression and the height of MVD (p < 0.05). Kaplan-Meier analyses revealed that VEGF expression and MVD had a statistically significant correlation with survival after curative resection (p < 0.05). Furthermore, multivariate analysis indicated that VEGF expression is an independent prognostic marker for cancer recurrence within 8 months after curative surgery (p = 0.003).<br />Conclusion: In pancreatic adenocarcinoma, the VEGF expression and the height of MVD are closely correlated, and both-rather than UICC stage and TNM classification (tumor size and nodal involvement)-are markers of prognostic relevance after curative resection. Furthermore, VEGF is a predictor of early recurrence after curative resection. The current study indicates that VEGF may promote the distribution of metastases, leading to early cancer recurrence and poor outcome.
- Subjects :
- Antigens, CD34 analysis
Blood Vessels chemistry
Blood Vessels pathology
Carcinoma, Pancreatic Ductal genetics
Carcinoma, Pancreatic Ductal surgery
Endothelial Growth Factors metabolism
Female
Follow-Up Studies
Gene Expression Regulation, Neoplastic
Humans
Immunohistochemistry
In Situ Hybridization
Lymphokines metabolism
Male
Middle Aged
Neoplasm Recurrence, Local
Pancreatic Neoplasms genetics
Pancreatic Neoplasms surgery
Predictive Value of Tests
Prognosis
RNA, Messenger genetics
RNA, Messenger metabolism
Survival Analysis
Vascular Endothelial Growth Factor A
Vascular Endothelial Growth Factors
Carcinoma, Pancreatic Ductal pathology
Endothelial Growth Factors genetics
Lymphokines genetics
Pancreatic Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1536-4828
- Volume :
- 25
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Pancreas
- Publication Type :
- Academic Journal
- Accession number :
- 12142733
- Full Text :
- https://doi.org/10.1097/00006676-200208000-00002