Japanese Journal of Clinical Oncology Advance Access originally published online on August 1, 2009
Japanese Journal of Clinical Oncology 2009 39(10):644-650; doi:10.1093/jjco/hyp079
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© The Author (2009). Published by Oxford University Press. All rights reserved
Expression of VEGF-C Correlates with a Poor Prognosis Based on Analysis of Prognostic Factors in 73 Patients with Esophageal Squamous Cell Carcinomas
1 Department of Digest Disease, The First Affiliated Hospital of Soochow University
2 Department of Digest Disease, Gastrointestinal Center, Jiangyin People's Hospital, Medical School of University of Southeast of China
3 Department of Digest Disease, The First Affiliated Hospital of Nanjing Medical University
4 Department of Internal Medicine, Zouping TCM Hospital, People’s Republic of China
5 Pacific Cancer Centre, Singapore
6 AmMed Cancer Center, Ruijin Hospital, Medical School of Shanghai Jiaotong University, Shanghai, People’s Republic of China
For reprints and all correspondence: Pengfei Liu, Department of Digest Disease, Gastrointestinal Center, Jiangyin People's Hospital, Medical School of University of Southeast of China, No. 163, Shoushan Road, Jiangyin 214400, Jiangsu Province, People’s Republic of China. E-mail: drpengfei.liu{at}gmail.com; Daoyuan Wang, AmMed Cancer Center, Shanghai Ruijin Hospital, Medical School of Shanghai Jiaotong University, No. 197, Rui Jin Er Lu, Shanghai 200025, People’s Republic of China. E-mail: ghealth2008{at}gmail.com
Received April 30, 2009; accepted June 20, 2009
Objective: The purpose of this study was to specifically investigate the clinicopathological role of expression of vascular endothelial growth factor-C (VEGF-C) as well as the correlation with clinical outcomes in esophageal squamous cell carcinomas (ESCCs).
Methods: Seventy-three patients with ESCC resected in our institute were included in this study. Formalin-fixed paraffin-embedded specimens were stained for VEGF-C and the correlation between the staining, its clinicopathological parameters and its prognostic power were analyzed statistically.
Results: Of the 73 ESCC patients studied, 39 cases (53.4%) were strongly positive for VEGF-C. Six cases (8.2%) were negative and 28 cases (38.4%) revealed unclear weak reactions. All 34 cases were included in the negative group (46.6%). VEGF-C expression correlated with histological grade (P = 0.005), depth of tumor invasion (pT) (P = 0.021), lymph node metastasis (pN) (P = 0.002) and lymphatic invasion (P = 0.008). The median overall survival of 39 patients who had positive staining for tumor cell VEGF-C and 34 patients who had negative staining were 10.4 months (95% CI, 6.9–13.9 months) and 28.5 months (95% CI, 12.6–44.4 months), respectively (P = 0.003). In univariate analysis by log-rank test, histological grade, pN, stage, lymphatic invasion and VEGF-C were significant prognostic factors (P = 0.047, 0.007, 0.018, 0.002 and 0.003, respectively.). In multivariate analysis, high VEGF-C expression (P = 0.0451) maintained its independent prognostic influence on overall survival, as well as pN status (P = 0.0029).
Conclusions: Expression of VEGF-C is related to histological grade, pT, pN and lymphatic invasion, and is a prognostic indicator for ESCC.
Key Words: esophageal squamous cell carcinomas • vascular endothelial growth factor-C • prognostic factors