CORRELATION BETWEEN EXPRESSION OF VASCULAR ENDOTHELIAL GROWTH-FACTOR AND TUMOR VASCULARITY, AND PATIENT OUTCOME IN HUMAN GASTRIC-CARCINOMA

Purpose: The relationship between the expression of vascular endotheli al growth factor (VEGF) and its receptor, KDR, in human gastric carcin oma tissues and tumor angiogenesis, as well as patient outcome, were i nvestigated. Materials and Methods: One hundred sixty-three primary tu mor specimens were investigated by immunohistochemical studies with an ti-VEGF, anti-KDR, and anti-CD34 antibodies and by monitoring patients for at least 2 years after surgery. Results: For intensity of VEGF st aining, 48 tumors were graded as 0, 36 as 1+, 63 as 2+, and 16 as 3+. Tumors with strong VEGF staining, assessed as 2+ and 3+, had significa ntly higher vascularity than those with weak VEGF. Eighty-eight tumors (54%) were positive for KDR. There was no association between KDR exp ression and tumor vascularity. No close correlation was found between VEGF and KDR expressions. The Cox propertional hazards model identifie d intratumoral vessel count as the most significant and independent pr ognostic factor among various clinicopathologic factors. In contrast, overall survival rates for 84 patients with weak VEGF staining tumors and 79 with strong VEGF staining tumors were not significantly differe nt. Patients with tumors of either localized Borrmann types or well-di fferentiated histologies, which are found more frequently in rumors wi th strong VEGF staining, survived significantly longer than those with tumors of either infiltrative Borrmann types or poorly differentiated histologies. Conclusion: We suggest that expression of VEGF is more f requently found in tumors with well-differentiated histology and ploys a role in the promotion of angiogenesis in human gastric carcinomas. (C) 1997 by American Society of Clinical Oncology.