Correlation between extent of tumor vascularization, prognosis and hematogenous metastases in gastric carcinoma using vascular endothelial growth factor [VEGF] and Von-Willebrand factor

ABSTRACT

Angiogenesis has a crucial importance for tumor growth and development of metastasis. This study aimed to evaluate angiogenesis. Microvessel density [MVD] was counted by staining endothelial cells immunohistochemically using anti von Willebrand vWF [factor VIII] antibody as well as vascular endothelial growth factor [VEGF], a known endothelial proliferative and mitogenic marker. Thirty prospective cases [24 cases of adenocarcinoma and 6 of diffuse infiltrating tumors] were enrolled in this study. Then, four cases were excluded from the study because they had inoperable tumors. Thus, a total of 26 patients was studied histologically, immunohistochemically and followed up for a period ranging from 6-30 months [median 12 months]. The immunohistochemical results of these biomarkers were correlated with standard prognostic factors [tumor grade, stage and lymph node metastasis] as well as overall survival period. It was found that MVD was significantly increased in deep advanced tumors and in the presence of nodal metastasis. However, VEGF positivity was demonstrated in only 46% of the cases and was not correlated with the clinicopathologic parameters. The MVD for cases that developed hematogenous metastasis was significantly higher than those having non metastatic tumors. Also, MVD was correlated with a relatively higher survival rates in favor of the hypovascular group