Immunohistochemical measurement of tumor vascular endothelial growth factor in breast cancer - A more reliable predictor of tumor stage than microvessel density or serum vascular endothelial growth factor

Microvessel density counting is commonly proposed as a method of assessing angiogenesis; However, results have been difficult to reproduce because of many methodological inconsistencies. Vascular endothelial growth factor (VE GF), an angiogenic regulator, is also a poor prognostic indicator in breast cancer, correlating in many studies with microvessel density. In this stud y, VEGF and microvessel density counting were examined as methods of assess ing angiogenesis in breast cancer and correlated with tumor stage. A repres entative tumor section was stained with anti-CD34 and anti-VEGF. Microvesse l density was evaluated using the manual "hot-spot" procedure and a semiqua ntitative image analysis system. Serum VEGF levels were available from an a dditional nine patients. Results were analyzed using Kendall's tall correla tion. Tumor stage correlated with tumor VEGF, but not with microvessel "hot -spot" or vessel counts. There was no correlation between scores obtained f rom the manual or semiquantitative methods. Serum VEGF did not correlate wi th either tumor VEGF or tumor stage. The prognostic importance of VEGF in i nvasive breast cancer is associated with tumor stage. Measurement of tumor VEGF, as an indicator of angiogenesis, is more reliable prognostically than measurement of microvessel density or serum VEGF. Routine measurement of m icrovessel density in breast cancer is less reliable.