Expression of vascular endothelial growth factor C is a prognostic indicator in esophageal cancer.

Abstract

BACKGROUND/AIMS: Vascular endothelial growth factor plays an important role in angiogenesis and vascular endothelial growth factor-C is concerned with lymphangiogenesis. METHODOLOGY: The present study employed immunostaining to investigate the relationship between expression of these factors and clinicopathologic findings in 100 patients with esophageal cancer. RESULTS: Fifty-six of the 100 tumors (56%) showed expressed vascular endothelial growth factor and 43 tumors (43%) expressed of vascular endothelial growth factor-C. Expression of the latter was correlated with the depth of tumor invasion (p=0.0095), lymphatic invasion (p=0.0065), lymph node metastasis (p=0.0l34). The prognosis was significantly worse for patients with tumors positive for vascular endothelial growth factor-C than for those with negative tumors (p=0.036). In contrast, expression of vascular endothelial growth factor was not correlated with the prognosis. Microvessel density was significantly higher in tumors expressing vascular endothelial growth factor-C compared with negative tumors (p=0.0014). Stepwise multivariate analysis with Cox's proportional hazards model identified gender (p=0.0420), age (p=0.0192), vascular endothelial growth factor-C expression (p=0.0286), and lymphatic invasion (p=0.0030) as prognostic determinants. CONCLUSIONS: Expression of vascular endothelial growth factor-C is related to lymphatic invasion and is a prognostic indicator for esophageal cancer.