Angiogenesis in the neoplastic sequence of Barrett's oesophagus. Correlation with VEGF expression

The purpose of this study was to determine the angiogenic profile of human oesophageal adenocarcinoma, This study was carried out on a large series of surgically resected Barrett's adenocarcinomas and associated preneoplastic lesions, Vascularization was quantified bg microvessel counting and measur ement of the percentage microvessel surface area after immunohistochemistry using the CD34 antibody. The expression of vascular endothelial cell growt h factor (VEGF) was also examined by immunohistochemistry. Results were cor related with clinico-pathological data and prognosis. Vascularization, asse ssed by both microvessel counting and measurement of the microvessel surfac e, mas statistically higher in superficial cancers than in others. Higher v ascularization was correlated with a lower rate of lymph node and distant m etastasis, as well as with better survival. However, when superficial carci nomas were excluded from the study, microvessel count failed to pro,ide any significant prognostic information. Irrespective of the inclusion or exclu sion of superficial tumours, the expression of VEGF was correlated with a h igher vascularisation but did not pro,ide prognostic significance. It is co ncluded that high angiogenic properties are acquired in precancerous lesion s and early cancers in Barrett's oesophagus. Vascularization as assessed by both microvessel counting and measurement of the microvessel surface is no t informative for prognosis in infiltrative Barrett's adenocarcinomas. The expression of VEGF is correlated with vascularization, but has no independe nt prognostic relevance. Copyright (C) 2000 John Wiley & Sons, Ltd.