EXPRESSION OF VASCULAR ENDOTHELIAL GROWTH-FACTOR (VEGF) IN EPITHELIALOVARIAN NEOPLASMS - CORRELATION WITH CLINICOPATHOLOGY AND PATIENT SURVIVAL, AND ANALYSIS OF SERUM VEGF LEVELS

Vascular endothelial growth factor (VEGF) is known to be produced by v arious solid tumours and is thought to be involved in microvascular pe rmeability and/or angiogenesis. To examine the relationship between VE GF expression in ovarian neoplasms and clinicopathological factors or patient survival, expression of VEGF was analysed immunohistochemicall y in 110 epithelial ovarian tumours. In addition, VEGF levels in the t umour fluid (17 patients), ascites (12 patients) and sera (38 patients ) were determined using enzyme immunoassay. Positive immunostaining fo r VEGF was observed in 97% (68 out of 70) of ovarian carcinomas, which was significantly higher than that of tumours of low malignant potent ial (LMP) (13 out of 25; 52%) and benign cystadenomas (5 out of 15; 33 %) (P < 0.01). In ovarian carcinomas, strong VEGF immunostaining was a lso observed more frequently in tumours of clear cell type (P < 0.05) in the advanced stage of disease (P < 0.05) and with positive peritone al cytology (P < 0.01). Patients with strong VEGF staining had poorer survival rates than those with weak or no immunostaining for VEGF (P < 0.01). These findings suggest that strong VEGF expression plays an im portant role in the tumour progression of ovarian carcinoma. The enzym e immunoassay revealed higher serum VEGF levels in carcinoma patients than those in patients with LMP or benign tumours (P < 0.01). Serum VE GF levels decreased after the successful removal of tumours in ovarian cancer patients and, in one patient, the serum VEGF level was re-elev ated during relapse. Therefore, serum VEGF could be used as a marker f or monitoring the clinical course of ovarian cancer patients.