The predictive value of vascular endothelial growth factor and nm23 for the diagnosis of occult metastasis in non-small cell lung cancer

We assessed the association of vascular endothelial growth factor (VEGF) an d nm23 expression with occult micrometastasis in lung cancer. As destinatio n sites for micrometastasis, we scrutinized lymph node (LN) and bone marrow (BM) specimens. For LN, 122 stage I patients who had received curative ope rations were studied. As regards BM, 203 patients in stage I-IV who underwe nt operations were registered. Immunohistochemical anti-cytokeratin stainin g was used to detect microdissemination of cancer cells. The VEGF and the n m23 expression at the primary sites were immunohistochemically studied in 2 85 eases in total. The percentages of the patients with microdissemination were 28.7% for LN and 42.4% for BM. The outcome for the patients with LN or BM microdissemination was significantly worse than that for patients witho ut it. The increased VEGF and the decreased nm23 expression within primary tumors were significantly associated with LN and BM microdissemination, The results indicate possible value of using these biological markers to predi ct the risk of systemic micrometastasis in non-small cell lung cancer.