Intensity of vascular endothelial growth factor expression is associated with increased risk of recurrence and decreased disease-free survival in papillary thyroid cancer
Cm. Lennard et al., Intensity of vascular endothelial growth factor expression is associated with increased risk of recurrence and decreased disease-free survival in papillary thyroid cancer, SURGERY, 129(5), 2001, pp. 552-558
Background, Vascular endothelial growth factor (VEGF) induces proliferation
of endothelial cells, stimulates angiogenesis, and increases vascular perm
eability. Increased VEGF expression has been associated with poor clinical
outcomes in many malignancies. Several recent reports have documented over
expression of VEGF in papillary thyroid cancer. We hypothesized that increa
sed expression of I VEGF would be associated with either an increased risk
of recurrence or a decreased recurrence-free survival in papillary thyroid
cancer.
Methods, Immunohistochemistry was used to detect VEGF expression in archiva
l paraffin-embedded surgical thyroid specimens from 96 subjects with papill
ary thyroid cancer
Results, VEGF expression was detected in 98% (94/96) of the samples, predom
inantly of slight-to-moderate intensity in the majority of malignant cells.
However, the specific finding of a diffuse pattern of intense immunostaini
ng for VEGF was detected significantly more often than less intense, patchy
immunostaining patterns in subjects with distant metastasis at diagnosis (
63% versus 15%, P =.005), local recurrence (58% versus 13%, P =.001), and d
istant recurrence (83% versus 14%, P =. 001). Furthermore, this specific pa
ttern of diffuse, intense VEGF expression was associated with a significant
ly shorter recurrence-free survival than other staining patterns (P =.007).
Conclusions:. These data demonstrate that the immunohistochemical pattern o
f VEGF staining in the initial surgical specimen is strongly associated wit
h the incidence of local and distant metastasis in papillary thyroid cancer
.