Prognostic Value of Tumor Angiogenesis in Advanced Gastric Carcinomas

ABSTRACT

BACKGROUND: Tumor angiogenesis is considered to be essential for tumor growth and progression. Recently, new technology for counting microvessels using antifactor-VIII-related antigen antibody, which recognizes endothelial cells, has been developed. In order to evaluate whether tumor angiogenesis can be used as an independent prognostic factor in advanced gastric carcinomas. We counted tumor microvessels, and we investigated the relationship between microvessel count and progression of a gastric carcinoma, by using a multivariate analyses. METHODS: Seventy (70) patients with advanced gastric carcinomas who had undergone a gastrectomy at Gyeongsang National University Hospital from January 1990 to December 1994 were evaluated by staining with a monoclonal antibody against F-VIII RAg. Microvessel counts were determined by immunohistochemical staining of a monoclonal antibody against F-VIII RAg, which was localized to the vascular endothelium. The correlation between the microvessel count (the mean number of microvessels in the three areas of highest vascular density at 200 times magnification) and the prognosis was studied. RESULTS: The microvessel counts ranged from 2 to 99.8, and the mean was 26. The microvessel counts were significantly higher in patients with recurrence than in those without recurrence. In patients who had undergone a curative operation, the survival time in the hypervascular group was significantly shorter than that in the hypovascular group. Multivariate analysis indicated that the microvessel count was an independent prognostic factor in patients with a gastric carcinoma. CONCLUSIONS: Microvessel count may be a good prognostic indicator and may be useful as a predictor for recurrence in patients with a gastric carcinoma.