Correlation between spontaneous apoptosis and the expression of angiogenicfactors in advanced gastric adenocarcinoma

The aim of this study was to investigate whether angiogenic factors influen ce the occurrence of spontaneous apoptosis in advanced gastric cancer. The apoptotic indices (AIs) of 97 tumors from 97 patients with advanced gastric cancer (pT3, pN0, pM0, Stage II) were analyzed by the terminaldeoxynucleot idyl transferase-mediated deoxyuridine triphosphate biotin nick end labelin g (TUNEL) method. Intratumoral microvessel densities (IMVDs) of tumors stai ned with anti-CD34 monoclonal antibody were quantified under x 200 magnific ation using computer-assisted image analysis. The expressions of angiogenic factors, such as vascular endothelial growth factor (VEGF), thymidine phos phorylase (dThdPase), transforming growth factor-alpha (TGF-alpha), and p53 were analyzed immunohistochemically and compared with IMVDs and Als. The m ean IMVD of the 97 tumors was 365/mm(2) (range 147 - 990/mm(2)). The mean A l of tumors was 2.1% (range 0 - 11.3%). A significant inverse cor relation between the AIs and the IMVDs was shown (rho = -0.278, P = 0.0064). The mea n IMVDs of tumors with high expressions of dThdPase, TGF-alpha, or p53 were significantly higher than those of tumors with low expressions of these fa ctors. The mean Al of tumors with high expressions of dThdPase was signific antly lower than that of tumors with low expressions of dThdPase (P = 0.023 ). However, no significant correlations were detected between AIs and the e xpression levels of VEGF, TGF-alpha, or p53. In gastric cancer, dThdPase ma y play an important role in tumor progression by increasing microvessels an d by suppressing apoptosis of cancer cells.