Do angiogenesis and growth factor expression predict prognosis of esophageal cancer?

A retrospective study of surgically resectable esophageal cancers was under taken to determine the relationship between angiogenesis score and growth f actor expression with tumor size, histology, degree of differentiation, dep th of invasion, nodal disease, and the presence of Barrett's esophagus. The office and hospital charts of 27 patients who had esophageal resection for carcinoma between 1990 and 1995 at Rush-Presbyterian-St. Luke's Medical Ce nter were reviewed. Data collection included patient demographics, survival , tumor size, histology, differentiation, depth of invasion, nodal metastas es, and the presence of Barrett's esophagus. The pathology specimens were i mmunostained for von Willebrand factor (factor VIII-related antigen). Immun ostaining was also performed for vascular endothelial growth factor and tra nsforming growth factor at. Twenty normal esophageal specimens served as co ntrols. Angiogenesis score was determined by counting vessels under convent ional light microscopy at x200 magnification, and growth factor expression was graded on a scale of 1 to 4. Cancers had higher angiogenesis and growth factor expression than controls (P = 0.01). Patient age, tumor size, histo logy, differentiation, depth of invasion, and Barrett's esophagus did not c orrelate with angiogenesis score or tumor growth factor expression. Lymph n ode status did correlate with both angiogenesis score and growth factor exp ression (P less than or equal to 0.02). We conclude that high angiogenesis score and growth factor expression correlate with the presence of lymph nod e metastases. This may help select patients for preoperative radiation and chemotherapy or determine the extent of surgery performed for esophageal ca rcinoma.