Serum levels of vascular endothelial growth factor dependent on the stage progression of lung cancer

Study objective: In lung cancer, vascular endothelial growth factor (VEGF) is an important cytokine and is correlated with tumor vessel density, malig nant pleural effusions, and coagulation-fibrinolysis factors in vitro. We i nvestigated the correlation between serum VEGF level and stage progression in lung cancer to study the predicted value of VEGF level. We also studied whether coagulation-fibrinolysis factors and Pao(2) levels, which are also important factors for the prediction of the clinical course, are correlated with VEGF. Methods: Forty-nine patients with lung cancer were investigated prospective ly. VEGF levels of sera and malignant effusions, and plasma concentrations of coagulation-fibrinolysis factors were measured by enzyme-linked immunoso rbent assay. We measured Pao(2) levels in all patients at rest. Results: Serum levels of VEGF were increased significantly according to sta ge progression. Additionally, plasma concentrations of D dimer, thrombin-an tithrombin complex (TAT), and tissue plasminogen activator/plasminogen acti vator inhibitor type I complex were elevated significantly according to sta ge progression. The serum VEGF level had a significant positive correlation with the TAT and D dimer levels. Serum VEGF levels had a significant negat ive correlation with Pao(2) levels. The incidence of cerebral vascular diso rder was significantly higher in the patients with systemic hypoxemia than in those without (p < 0.05). Mean VEGF levels in malignant effusions in eig ht patients (five with pleural effusions, two with pericardial effusions, a nd one with both) were extremely high, especially in pericardial effusions ([mean +/- SD] pleural effusions, 531.9 +/- 285.4 pg/mL; pericardial effusi on, 3,071.6 +/- 81.3 pg/mL). Conclusion: We predict that in lung cancer, VEGF production and the abnorma lity of the congulation-fibrinolysis system differ depending on the stage o f progression of disease. Serum VEGF levels would be affected by Pao(2) lev els in lung cancer.