Prognostic value of vascularity and vascular endothelial growth factor expression in non-small cell lung cancer

Aims-High expression of the angiogenic factor vascular endothelial growth f actor (VEGF) in tumours has been found to be associated with poor prognosis in some studies, but not in others. The aims of this study were to determi ne the prognostic value of VEGF in operable non-small cell lung cancer (NSC LC) and its possible association with vascularity. Methods-Sections from 81 NSCLC archival specimens were stained with antibod ies to von Willebrand factor (VWF) and VEGF. Vascularity was measured by th e average density of VWF positive vessels. VEGF expression in tumour cells was assessed by consensus of two independent observers according to three i ndices, namely: (I) percentage of area stained, (2) intensity of staining, and (3) final score (product of area and intensity). Results-VEGF immunoreactivity was present in all tumours and adjacent norma l lung tissue. None of the three VEGF indices was associated with vasculari ty or the clinical parameters examined. Mean survival times were shorter in patients with high VEGF expression, but the difference was not significant . This applied to the full cohort of patients, or when analysed separately according to present normal However, high VEGF expression was associated wi th poor survival in patients with high vascularity (p = 0.02). VEGF had no discriminant value among patients with low vascularity. Vascularity had no prognostic value, except for late stage patients (UICC stages II and IIIa c ombined; n = 36), where high vascularity was associated with longer surviva l (p = 0.01). Conclusions-VEGF on its own has no prognostic value in NSCLC, but may becom e a useful indicator when combined with vascularity. VEGF may play a physio logical role in the normal lung.