重组人VEGF-C和VEGF-D对人淋巴管内皮细胞增殖的影响

目的探讨VEGF-C及VEGF-D对人淋巴管内皮细胞增殖、促进淋巴管新生的机制。方法体外培养人淋巴管内皮细胞,用重组人VEGF-C、VEGF-D及VEGF-C+VEGF-D分别刺激后,计算细胞增殖率,比较各组细胞增殖情况。结果体外培养的淋巴管内皮细胞在加入重组人VEGF-C、VEGF-D试剂后细胞均增殖活跃。VEGF-D组增殖率为(54.2±4.35)%,VEGF-C组增殖率为(62.5±5.67)%,VEGF-C+VEGF-D组增殖率为(74.3±5.08)%,与对照组差异有显著性(P0.05)。结论重组人VEGF-C与VEGF-D能刺激体外培养人淋巴管内皮细胞增殖。     

喉癌中血管内皮生长因子C与淋巴转移的关系

目的：探讨喉癌中血管内皮生长因子C（Vascular endothelial growth factor-C，VEGF-C）的表达与淋巴道转移的关系。方法：免疫组化SP法，对54例喉癌组织行VEGF-C检测及癌周组织毛细淋巴管计数，应用全自动图像分析仪对染色结果进行定量测定，以平均灰度值表示VEGF-C的染色强度。结果：喉癌组织内VEGF-C表达高于声带息肉（P〈0．05）；颈淋巴结转移组高于非转移组（P〈0．01）。癌周组织毛细淋巴管密度高于对照组正常喉组织（P〈0．01）；颈淋巴结转移组高于非转移组（P〈0．01）。喉癌组织内VEGF-C表达与癌周组织淋巴管密度呈正相关（r=0．603，P〈0．01）。结论：喉癌组织中VEGF-C的表达与癌周毛细淋巴管密度关系密切，VEGF-C高表达促进淋巴管增殖，促进淋巴道转移。     

VEGF-C与VEGF-D比值变化与肿瘤淋巴道转移的研究进展

肿瘤侵袭周边原有淋巴管以及诱导组织内新生淋巴管的形成,是肿瘤淋巴道转移的必要条件。VEGF-C和VEGF-D是特异性淋巴管生长调节因子,与淋巴管的增生和分化密切相关。二者的比值升高可能是肿瘤淋巴道转移的早期事件和潜在评估指标。本文介绍VEGF-C和VEGF-D的结构、功能、比值变化以及二者与肿瘤淋巴道转移关系的研究进展。     

Lymphangiogenesis induced by VEGF-C and VEGF-D promotes metastasis and a poor outcome in breast carcinoma: a retrospective study of 61 cases

Purpose To evaluate lymphangiogenesis in patients with breast carcinoma, explore the underlying mechanism, and study the relationship between lymphangiogenesis and progression of breast carcinoma. Methods Sixty-one cases of breast carcinoma with complete clinical and pathological data were analyzed. Using an anti-podoplanin monoclonal antibody, an immunohistochemical study was made of all specimens to detect lymphatic vessel density (LVD) and to investigate its clinicopathological and prognostic value. VEGF-C and VEGF-D were observed by RT-PCR and immunostaining to investigate their clinicopathological and prognostic values and their relationship with lymphangiogenesis. Results LVD in breast carcinoma (6.28 ± 3.73) was significantly higher than in benign mammary lesions (0.50 ± 1.27), P < 0.01 and was significantly associated with lymphatic metastasis and high TNM stage, P < 0.01. The level of VEGF-C and VEGF-D expression was also significantly higher in breast carcinomas than in benign mammary lesions, P < 0.01. LVD increased significantly with higher expression of VEGF-C and VEGF-D, P < 0.01. Patients with high expression of VEGF-C and VEGF-D were observed to be more likely to have a bad outcome, P < 0.05. Conclusions Lymphangiogenesis was significantly associated with lymph node metastasis, high TNM, and poor outcome in breast carcinoma. LVD may serve as a predictor of lymph node metastasis and a prognostic factor in breast carcinoma. VEGF-C and VEGF-D play an important role in lymphangiogenesis making the carcinoma more aggressive and leading to a poor prognosis.     

甲状腺乳头状癌中VEGF-C和VEGF-D的表达及相关性及与临床病理特征的关系

目的探讨淋巴管生成因子VEGF-C、VEGF-D在甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的蛋白表达及与临床病理特征的关系及表达相关性。方法对105例PTC进行VEGF-C和VEGF-D的免疫组化检测,以相应的癌旁正常甲状腺组织相对照,原位观察两者在甲状腺乳头状癌的蛋白表达,分析两者与临床病理特征的关系及两者表达的相关性。结果 (1)甲状腺乳头状癌中瘤组织VEGF-C和VEGF-D蛋白均高表达,表达率分别达54.3%(57/105)和74.3%(78/105)。(2)PTC中VEGF-C、VEGF-D蛋白表达在淋巴结转移阳性组较阴性组明显增强,差异具有统计学意义(P0.05)。(3)PTC中VEGF-C、VEGF-D两者蛋白表达呈正相关(r=0.466,P0.01)。结论甲状腺乳头状癌的瘤细胞VEGF-C、VEGF-D蛋白高表达在淋巴道转移中可能发挥了重要的作用。两者蛋白表达呈正相关,提示两者可能具有相似的诱发因素或彼此之间有协同作用。     

Expression of vascular endothelial growth factor-C and its receptor in osteosarcomas

Vascular endothelial growth factor-C (VEGF-C) and its receptor, vascular endothelial growth factor receptor-3 (VEGFR-3), have been implicated as important factors in the formation of lymphatic vessels, but its role in osteosarcomas has not yet been fully investigated. This study aims to define the expression of VEGF-C and VEGFR-3 in primary and metastatic osteosarcomas and their relationship to various clinicopathologic parameters. Thirty-three primary osteosarcomas and two pulmonary metastatic samples were immunostained for VEGF-C and VEGFR-3. In addition, VEGF-C and vascular endothelial growth factor-D (VEGF-D) mRNA expression levels in three different human osteosarcoma cell lines and control fibroblasts were evaluated by real-time quantitative polymerase chain reaction (PCR). Both VEGF-C and VEGFR-3 were expressed mainly in the cytoplasm of the tumor cells. Of the 35 patients with osteosarcoma, 16 patients (45.7%) showed strong positive reaction with VEGF-C. Four cases (11.4%) were negative, and 15 cases (42.9%) showed weak immunoreactivity. For VEGFR-3, 12 patients (34.3%) showed strong positive reaction. Fifteen cases (42.9%) were negative, and eight cases (22.8%) showed weak immunoreactivity. A significant, positive correlation (Rs=0.42, p=0.01) was found between the expression of VEGF-C and VEGFR-3 in osteosarcomas. The expression of VEGF-C was significantly associated with the osteoblastic subtype and high histologic grade in osteosarcomas. However, the expression of VEGF-C showed no significant correlation with the presence of metastasis. Expression of VEGFR-3 was not related to any clinicopathologic features analyzed. Two of the three osteosarcoma cell lines tested showed amplification of VEGF-C mRNA compared with control cells. No amplification of VEGF-D was noted in these cell lines. Our data suggest that VEGF-C and its receptor are expressed in osteosarcomas. Although the level of VEGF-C was high, it does not seem to have a direct influence on tumor metastasis in osteosarcomas.     

New insights into tumor-host interactions in lymphoma metastasis

The metastatic process is characterized by a complex series of sequential steps involving constant interactions (mutual cross-talks) of metastasized tumor cells with their microenvironment (lymphocyte, macrophages, endothelial cells, etc.) in target organs. These interactions determine the outcome of metastasis (either the eradication of metastatic cells or their increased proliferation and invasion). Recently developed methods of tumor and host cell analysis at the molecular level allow better elucidation of molecular mechanisms of metastasis and of immune mechanisms involved in antitumor responses. Direct modulation of these processes will probably increase the success of clinical cancer treatment. Here we review data (a) on the expression of some costimulatory (MHC class II, CD80, sialoadhesin) and adhesion (LFA1, ICAM-1, VLA-4) molecules on both metastasized tumor cells and host cells and (b) on the production of a cytotoxic molecule, nitric oxide, by in situ activated Kupffer and endothelial cells in the process of liver metastasis. This study was performed with well-characterized murine ESbL T lymphoma cells transduced with the bacterial lacZ gene, which allows detection and quantification of metastases at the single cell level throughout lymphoma growth and metastasis. Experimental results are discussed in the context of recent literature.Abbreviations APC Antigen-presenting cells - hCRP Human C-reactive protein - ICAM Intercellular adhesion molecule - IFN Interferon - IL Interleukin - iNOS Inducible NO synthase - LFA Leukocyte function associated antigen - SER Sheep erythrocyte receptor - TA Tumor-associated rejection antigens - TNF Tumor necrosis factor - VCAM Vascular cell adhesion molecule - VLA Very late activated antigen     

血管内皮生长因子C和趋化因子受体CCR7的表达与膀胱癌淋巴结转移之间的关系

目的观察血管内皮生长因子(VEGF)-C和趋化因子受体CCR7在膀胱移行细胞癌组织内的表达情况,分析VEGF-C和CCR7表达与癌淋巴结转移之间的关系。方法取膀胱癌病例60例,其中,淋巴结转移组36例,无淋巴结转移组24例。应用免疫组化法和Western blot技术观察VEGF-C和CCR7在膀胱癌组织内的表达。结果 VEGF-C和CCR7主要表达于膀胱癌细胞胞浆或/和胞膜内,二者在淋巴结转移组的表达率明显高于无淋巴结转移组。VEGF-C和CCR7蛋白同时表达在淋巴结转移组和非淋巴结转移组中的表达率分别为61.1%和33.3%,VEGF-C和CCR7的表达具有显著的相关性,联合检测VEGF-C和CCR7诊断膀胱癌淋巴结转移具有较高的准确度,ROC曲线下面积达0.708。结论 VEGF-C和CCR7在促进膀胱癌淋巴结转移中可能具有一定的协同作用,二者联合检测有助于膀胱癌淋巴结转移的早期诊断     

Quantification of vascular endothelial growth factor-C (VEGF-C) by a novel ELISA

Lymphangiogenesis plays an important role in several normal and pathological conditions such as wound healing, inflammation or metastasis formation in several malignancies. VEGF-C and VEGF-D are important and specific regulatory factors for lymphatic endothelial proliferation and lymphangiogenesis. In order to develop a highly sensitive and specific detection system for VEGF-C, we produced soluble binding proteins and antibodies for a microtiterplate-based assay. Here we describe a specific enzyme-linked immunosorbent assay (ELISA) for the measurement of human, rat and murine VEGF-C. The different antibodies developed against human and rat VEGF-C could be combined to detect processed and partially processed VEGF-C in a specific way. The ELISA was able to detect human and rat VEGF-C with a minimum detection limit of 100 pg/ml. The assay did not show any cross-reactivity with the related protein VEGF-D. Furthermore, complex formation with its soluble receptors VEGFR-2 and VEGFR-3 did not restricted the sensitivity of the assay. Using this assay, VEGF-C was measured in supernatants and lysates of different cell types and in tumour tissue samples of murine, rat and human origin. Cell lines secrete VEGF-C in very low amounts (<1 ng/ml) whereas VEGF-C transfected cells can secrete up to 50 ng/ml VEGF-C into the supernatant. In human tumour tissue samples VEGF-C was detected in some carcinomas in the low protein range. This ELISA will be a useful tool for investigations concerning the physiological function of VEGF-C in lymphangiogenesis under normal and pathophysiological conditions.     

Intratumoral heterogeneity of macrophages and fibroblasts in breast cancer is associated with the morphological diversity of tumor cells and contributes to lymph node metastasis

Recent studies have highlighted the heterogeneity of the tumor microenvironment (ME) and the importance of its analysis to the understanding of its impact on clinical outcomes. In this study, we aimed to analyze the intratumoral distribution of macrophages and fibroblasts in breast cancer (BC) based on the morphological diversity of tumor cells (tubular, alveolar, solid, trabecular and discrete structures) and the clinicopathological parameters of the disease. Thirty-six patients with invasive breast carcinoma of no special type were included in the study. The distribution of macrophages and fibroblasts in the MEs of different morphological structures was assessed using laser microdissection-assisted quantitative RT-PCR analysis of marker genes and double immunofluorescence staining for the CD68, RS1, aSMA, and FAP proteins. Gene expression microarrays were used to determine the expression of genes involved in the regulation of macrophage and fibroblast phenotypes in different morphological structures. We found that different macrophage and fibroblast subpopulations were simultaneously observed in the MEs of morphologically distinct structures but that the frequency of their detection and number of cells detected varied significantly among these structures. In particular, macrophages and fibroblasts were more frequently detected in the ME of solid structures and were rarely observed in tubular structures. A high number of CD68⁺RS1⁺ macrophages in the ME of solid structures was found to be associated with an increased frequency of lymph node metastasis in luminal B HER2⁻ BC. In contrast, in luminal B HER2⁺ BC, lymph node involvement was related to the high representation of aSMA⁺FAP⁺ fibroblasts around trabecular structures. Morphologically distinct structures differed in the mechanisms regulating the macrophage and fibroblast phenotypes. The highest number of overexpressed genes controlling macrophage and fibroblast functions was observed in discrete groups of tumor cells, and the lowest number was observed in alveolar and solid structures. Taken together, our findings indicate the heterogeneous distribution of macrophages and fibroblasts in breast tumors and its close relation to the intratumoral morphological diversity of BC and contribution to lymph node metastasis.     

Expression of vascular endothelial growth factor C and anti-angiogenesis therapy in endometriosis

Angiogenesis is an important pathogenesis of Endometriosis. Vascular endothelial growth factor C (VEGF-C) is one of the most important factor in the regulation of both normal and abnormal angiogenesis. Anti-angiogenic treatment of endometriosis is still in the exploratory stage. In this study, we investigate the relationship between VEGF-C and endometriosis, the therapeutic effects of Endostar in the rat endometriosis model. We then demonstrated that Immunohistochemical expression of VEGF-C was higher in endometriotic tissues than in control normal ovary tissues (P < 0.01) and higher in the endomertriosis grade III-IV than in endomertriosis grade I-II (P=0.013). In rat endometriosis model, we observed a significant reduction in the mean volume and weight of the endometriotic implants per rat in the treatment group as compared with the control group. By immunohistochemical evaluation, there was a significant reduction in VEGF-C expression after treatment in all areas examined. VEGF-C may be involved in the pathogenesis of endomertriosis by regulating the angiogenesis. Endostar has therapeutic effects of endometriosis lesions in the rat endometriosis model.     

血管内皮生长因子C、D和受体3在人胰腺癌组织中的表达

目的:通过观察不同临床指标的人胰腺癌组织VEGF-C、VEGF-D、VEGFR-3的表达,来探讨VEGF-C和VEGF-D对人胰腺癌转移的影响,为癌组织中淋巴管的生成机制以及癌的淋巴道转移机制提供理论依据。方法:取人胰腺癌标本33例及癌旁正常胰腺组织15例,用免疫组化的方法观察VEGF-C、VEGF-D及VEGFR-3在人胰腺癌和癌旁正常胰腺组织中的表达。结果:VEGF-C、VEGF-D和VEGFR-3在胰腺癌组织中的表达比例较在癌旁正常胰腺组织中的表达比例明显增高,并且VEGFR-3的表达与VEGF-D的表达具有显著相关性(P<0.01),与VEGF-C的表达不具有相关性(P>0.05)。胰腺癌组织中VEGF-C和VEGF-D的表达与患者的年龄、性别、远处转移无关(P>0.05)。结论:VEGF-C、VEGF-D在胰腺癌组织中的表达明显增高,并有可能通过与VEGFR-3的结合促进了癌组织中淋巴管的生成,从而对癌的淋巴道转移起促进作用。     

抗人VEGF的单克隆抗体对乳腺癌生长及转移的影响

目的用具有中和活性的抗人血管内皮细胞生长因子（ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ，ＶＥＧＦ）单抗进行抑瘤动物实验，探讨ＶＥＧＦ在肿瘤生长及转移中的作用。方法采用杂交瘤技术制备抗ＶＥＧＦ的单抗，经亲和层析纯化单抗，在ＩＶＴ２ＭＡ－８９１津白ＩＩ小鼠自发乳腺癌伴肺转移动物模型中进行实验研究。结果Ｄ７、Ｅ５、Ｇ１、Ｃ５、Ｄ１１及Ｈ５６株单抗都能显著地抑制肿瘤的肺转移，对肺转移灶数的抑制率分别为４４％，４５％，６２％，７０％，７２％和７４％。对肺转移灶大小的抑制率为７９％～１００％。其中Ｄ７、Ｃ５、Ｇ１、Ｄ１１４株单抗也能明显地抑制原发瘤的生长。其抑制率分别为４１％，４６％，５３％和８３％。结论ＶＥＧＦ单抗能阻断肿瘤血管的形成，显著地抑制原发瘤的生长和转移，在肿瘤的治疗中显示出潜在的应用价值。     

The role of vascular endothelial cells in tumor metastasis

Vascular endothelial cells (VECs) are an integral component of the inner lining of blood vessels, and their functions are essential for the proper functioning of the vascular system. The tight junctions formed by VECs act as a significant barrier to the intravasation and extravasation of tumor cells (TCs). In addition to that, the proliferation, activation, and migration of VECs play a vital role in the growth of new blood vessels, a process known as tumor angiogenesis, which is closely related to the malignant progression of tumors. However, during tumor progression, VECs undergo endothelial-to-mesenchymal transition (EndMT), which further promotes tumor progression. Furthermore, VECs act as the first line of defense against effector immune cells and help prevent immune cells from infiltrating into tumor tissues. VECs also secrete various cytokines that can contribute to regulating the stemness of tumor stem cells. Thus, it has been increasingly recognized that dysfunction of VECs is one of the key driving forces behind tumor metastasis, and therapeutic strategies targeting VECs have the potential to be an effective means of antitumor therapy. This review aims to present a comprehensive overview of the role and mechanisms of VECs in regulating tumor progression and metastasis, providing insights into the possibilities for the development of novel antitumor therapies that target VECs.     

基质金属蛋白酶及其组织抑制因子在皮肤增生性瘢痕中的作用

目的探讨基质金属蛋白酶（MMPs）MMP2、MMP9及其抑制物（TIMPs）TIMP-1在皮肤增生性瘢痕中的作用。方法取3-6个月、6-12个月皮肤增生性瘢痕，以正常皮肤组织为对照，ELISA方法测定其MMP2、MMP9以及TIMP-1的含量，采用SPSS统计软件，以成组设计的单因素方差分析，分析它们在不同时段瘢痕组织中变化的意义。结果（1）3-6月瘢痕组织和6-12月瘢痕组织的MMP2，均较正常皮肤显著增高（110.70±5.23ng／ml VS 54.59±3.01，P〈0.01；77.23±7.10ng／ml VS 54.59±3.01，P〈0.01），而3-6月瘢痕组织的MMP2较6-12月瘢痕组织的MMP2亦有显著增高（110.70±5.23 VS 77．23±7．10，P〈0．01）；3-6月瘢痕组织和6-12月瘢痕组织的MMP9之间（3.85±0.88 VS 3.61±0.43，P〉0.05）以及它们与正常皮肤组织的MMP9相比（3.85±0.88 VS 4.13±0.33，P〉0.05；3.61±0.43 VS 4.13±0.33，P〉0.05）均无显著性差异；（2）3-6月瘢痕组织和6-12月瘢痕组织的TIMP-1与正常皮肤组织相比有显著增高（4．74±0．35 VS 3．01±0．11，P〈0．01；5．12±0．34 VS 3.01±0．11，P〈0．01），6-12月瘢痕组织较3-6月瘢痕组织的TIMP-1有显著增高（5.12±0.34 VS 4.74±0．35，P〈0．05）；（3）3-6月瘢痕组织和6-12月瘢痕组织的MMP2与TIMP-1的比值与正常皮肤组织相比均有显著增高（23．38±1．01 VS 18．15±0．58，P〈0.01；15.10±1.45 VS 18．15±0．58，P〈0．01），3-6月瘢痕组织较6-12月瘢痕组织的MMP2与TIMP-1的比值有显著降低（23.38±1.01 VS 15.10±1.45，P〈0.01）。结论MMPs以及TIMPs参与了皮肤瘢痕的增生过程，MMP2、TIMP-1含量及其比值可作为瘢痕生长和预后的指标。     

抑癌基因PTEN和血管内皮生长因子-C表达与乳腺癌淋巴管密度的相关性及其临床意义

目的:研究乳腺癌中抑癌基因PTEN和血管内皮生长因子-C(VEGF-C)表达与肿瘤间质淋巴管密度(LVD)的相关性及其临床意义。方法:应用EliVision免疫组化法检测90例乳腺浸润性导管癌组织和30例乳腺纤维腺瘤组织中PTEN、VEGF-C和淋巴管内皮细胞透明质酸受体1(LYVE-1)的表达,计算LYVE-1标记的乳腺癌间质淋巴管的密度,分析PTEN和VEGF-C与LVD的关系。结果:PTEN和VEGF-C在乳腺癌中的表达阳性率分别为48.9%、47.8%,LVD为(8.03±2.26)个/HPF,与良性对照组比较均有显著差异(P<0.01)。PTEN阳性率随乳腺癌淋巴结转移的出现和临床分期的升高而降低(P<0.05),乳腺癌VEGF-C阳性率随淋巴结转移的出现和临床分期的升高而增加(P<0.05),PTEN阳性组乳腺癌的LVD水平低于PTEN阴性组(P<0.05),VEGF-C阳性组乳腺癌的LVD水平高于VEGF-C阴性组(P<0.01),PTEN阳性组乳腺癌的VEGF-C阳性率低于PTEN阴性组(P<0.05)。结论:PTEN和VEGF-C的异常表达与乳腺癌间质淋巴管密度密切相关,在乳腺癌的淋巴管生成及侵袭转移过程中具有重要作用。     

小鼠肝癌细胞特异性淋巴道转移与其基质金属蛋白酶分泌的关系

目的　探讨肿瘤细胞基质金属蛋白酶 (MMPs)分泌与特异性淋巴结转移的关系。方法　将自建高、低转移小鼠肝癌细胞系HCa F(高转移 )和HCa P(低转移 )在培养时 ,分别加入淋巴结、肝脏或脾脏匀浆 ,离心收集培养上清 ,用明胶酶谱法检测两株癌细胞在不同培养环境下分泌的MMPs酶谱 ,分析两者的差异。结果　在单纯RPMI16 40培养基中HCa F和HCa P细胞仅能分泌少量MMP 9(12 5 6± 15 7,2 6 42± 385 ) ,加入淋巴结匀浆后HCa F细胞分泌MMP 9显著增强 (12 40 3± 894) ,且分泌MMP 9的活性型和MMP 2 ;HCa P细胞也分泌MMP 9(90 6 8± 6 86 )及其活性型 (3 914± 12 5 3)和MMP 2(2 997± 1990 ) ,但量均明显低于HCa F细胞 ;加入肝脏或脾脏匀浆后 ,HCa F和HCa P细胞均不分泌MMPs。结论　HCa F细胞强于HCa P细胞的转移能力可能与HCa F细胞分泌MMPs的能力强于HCa P细胞相关 ,而HCa F和HCa P细胞仅在淋巴结成分诱导下才能分泌较多的MMPs,这可能与它们具有特异性地向淋巴结转移的功能密切相关。     

Distinct roles of vascular endothelial growth factor-D in lymphangiogenesis and metastasis

In many human carcinomas, expression of the lymphangiogenic factor vascular endothelial growth factor-D (VEGF-D) correlates with up-regulated lymphangiogenesis and regional lymph node metastasis. Here, we have used the Rip1Tag2 transgenic mouse model of pancreatic beta-cell carcinogenesis to investigate the functional role of VEGF-D in the induction of lymphangiogenesis and tumor progression. Expression of VEGF-D in beta cells of single-transgenic Rip1VEGF-D mice resulted in the formation of peri-insular lymphatic lacunae, often containing leukocyte accumulations and blood hemorrhages. When these mice were crossed to Rip1Tag2 mice, VEGF-D-expressing tumors also exhibited peritumoral lymphangiogenesis with lymphocyte accumulations and hemorrhages, and they frequently developed lymph node and lung metastases. Notably, tumor outgrowth and blood microvessel density were significantly reduced in VEGF-D-expressing tumors. Our results demonstrate that VEGF-D induces lymphangiogenesis, promotes metastasis to lymph nodes and lungs, and yet represses hemangiogenesis and tumor outgrowth. Because a comparable transgenic expression of vascular endothelial growth factor-C (VEGF-C) in Rip1Tag2 has been shown previously to provoke lymphangiogenesis and lymph node metastasis in the absence of any distant metastasis, leukocyte infiltration, or angiogenesis-suppressing effects, these results reveal further functional differences between VEGF-D and VEGF-C.