血管内皮生长因子在食管癌中的表达及意义

为探讨血管内皮生长因子（VEGF）与食管癌生物学行为之间的关系,采用免疫组化SABC法检测了46例食管癌患者癌组织标本中的VEGF表达情况及微血管密度（MVD）。结果21例（45．65％）VEGF呈阳性表达;肿瘤浸润深度局限于肌层以内者的阳性表达率为30．43％,侵及外膜及邻近器官者为60．87％,差异有显著意义（P＜0．05）;肿瘤分化程度为Ⅱ、Ⅲ级者的VEGF阳性表达率显著高于I级者（P分别＜0．05、0．01）;各食管癌分期（PTNM）VEGF阳性表达率之间无显著差异（P＞0．05）;有、无淋巴结转移者的VEGF阳性表达率无显著差异（P＞0．05）。VEGF阳性者MVD值明显高于阴性者（P＜0．05）,其5年生存率（14．29％）低于VEGF阴性者（56％）,P＜0．05）。认为VEGF阳性表达与食管癌的分化程度、浸润深度有关,与食管癌的肿瘤大小、临床病理分期、淋巴结转移无关;VEGF阳性表达与食管癌的MVD密切相关;VEGF阳性表达者术后预后差;VEGF可为食管癌的诊断、预后判断及治疗方案选择提供重要依据。     

食管鳞癌组织中NF-κB p65、VEGF的表达及其与血管密度测定的意义

采用免疫组化S-P法检测61例食管鳞癌患者组织中核转录因子-κB（NF-κB）p65和血管内皮生长因子（VEGF）的表达及CD105标记的肿瘤内徽血管密度（MVD）。结果NF-κB p65表达与食管鳞癌的组织学分级、浸润深度和淋巴结转移均呈正相关（P均〈0．01）,VEGF蛋白表达及MVD与食管鳞癌组织学分级和浸润深度均无关,但与淋巴结转移呈正相关（P〈0．05）;NF-κB p65与VEGF表达呈正相关（P〈0．01）;二者均与MVD呈正相关（P均〈0．05）。提示NF-κB p65参与食管鳞癌的发生、发展,其机制可能与VEGF的表达和肿瘤血管生成有关。     

大肠癌组织中P16蛋白和血管内皮生长因子的表达及其临床意义

目的：探讨大肠癌组织中P16蛋白和血管内皮生长因子（VEGF）表达及其临床意认。方法：用S－P免疫组织化学方法测定66例大肠癌组织和20例正常大肠组织中P16蛋白和VEGF的表达。结果：大肠癌中P16蛋白阳性率为48．5％（32／66）明显低于对照组的70．0％（14／20）（P＜0．01），VEGF阳性率为72．7％（48／66）则明显高于对照组的15．0％（3／20）（P＜0．01）：P16蛋白和VEGF在大肠癌中表达具有明显负相关性；P16蛋白和VEGF表达与大肠癌组织学类型、肿瘤直径、肿瘤部位无关（P＞0．05），而与淋巴结转移、Duke's分期五年生存率有明显的关系（P＜0．01）。结论：大肠癌中存在P16蛋白下调和VEGF上调，P16蛋白和VEGF表达可作为反映大肠癌生物学行为的指标之一。     

血管内皮生长因子在喉癌中的表达及其与血管生成和转移的相关性

目的 探讨喉癌患者血管内皮生长因子(VEGF)水平与喉癌血管生成和转移的关系.方法 2006～2009年50例喉癌患者为病例组,20例声带息肉患者为对照组.应用免疫组织化学SABC法检测黏膜VEGF及微血管密度(MVD)的表达情况,分析VEGF水平与MVD的关系.结果 喉癌组VEGF及MVD的表达均明显高于对照组(P＜0.01),VEGF表达在肿瘤不同TNM分期和淋巴结转移中有统计学意义.结论 VEGF参与并促进了喉癌患者持续的血管再生,与喉癌生长、浸润及淋巴结转移密切相关,VEGF及MVD可作为判断喉癌预后的重要参考指标.     

VEGF和Ang-2与甲状腺乳头状癌血管生成和转移的相关性探讨

采用免疫组化S-P法检测20例甲状腺乳头状癌（PTC,A组）、15例结节性甲状腺肿（B组）、15例甲状腺腺瘤（C组）和15例正常甲状腺组织（D组）中血管内皮生长因子（VEGF）、促血管生成素-2（Ang-2）蛋白的表达和微血管密度（MVD）。结果A组VEGF和Ang-2表达均显著高于其他组（P均〈0．05）;A组VEGF、Ang-2与MVD呈正相关（P均〈0．05）,而Ang-2与MVD无相关性;A组有淋巴结转移者VEGF表达和MVD均显著高于无转移者（P均〈0．05）,但Ang-2无显著差异。提示VEGF和Ang-2在PTC血管生成中起重要作用;VEGF与PTC转移密切相关。     

survivin、VEGF、微血管密度在大肠癌中的黏膜组织表达及意义

应用免疫组织化学S-P法检测53例大肠癌、21例大肠腺瘤、12例健康人大肠黏膜中生存素（survivin）、血管内皮生长因子（VEGF）表达及微血管密度（MVD）。结果大肠癌中survivin、VEGF阳性率及MVD值均显著高于大肠腺瘤病变及正常大肠组织（P均〈0.05）。survivin表达水平与患者的性别、年龄、组织分化程度、临床分期、浸润深度、淋巴结转移无明显相关;VEGF表达水平及MVD与组织分化程度、浸润深度、临床分期、淋巴结转移有相关性。提示survivin在大肠癌的发生、发展中起重要作用,并参与了肿瘤血管的形成。     

Hpa、p53表达与大肠癌浸润转移的关系

目的 观察乙酰肝素酶（Hpa）及原癌基因053的表达变化与大肠癌浸润转移的关系。方法采用免疫组化EnVision法检测54例原发性大肠癌组织中的Hpa及p053蛋白。结果Hpa与大肠癌肿瘤直径有关（P〈0．01）,Hpa、p53与肿瘤浸润深度、淋巴结转移和肝转移有关（P均〈0．05）。结论Hpa和p53蛋白的表达在大肠癌浸润转移中起重要作用,联合检测Hpa和p53蛋白对判断大肠癌淋巴结和肝转移有一定参考价值。     

肺腺癌组织中VEGF-D的表达变化及意义

目的观察肺腺癌组织中血管内皮生长因子D（VEGF—D）的表达,探讨其意义。方法分别采用RT-PCR法、免疫组化法检测48例肺腺癌组织中的VEGF—D mRNA和VEGF—D、微淋巴管密度（MLVD）、微血管密度（MVD）。结果VEGF—D mRNA在肺腺癌组织中的表达高于正常肺组织（P〈0．01）,VEGF—D蛋白阳性率肿瘤周边显著高于肿瘤中心（P〈0．01）;其表达与肿瘤分化、MVD无关,与TNM分期、MLVD、淋巴结转移有关（P均〈0．05）。结论肺腺癌组织中VEGF—D高表达,与淋巴管的生成及转移有关。     

大肠癌微血管密度及增殖细胞核抗原与临床预后的关系

目的探讨大肠癌微血管密度(MVD)及增殖细胞核抗原(PCNA)与手术后有无潜在性肿瘤转移及复发的相关性.方法对55例大肠癌进行术后5 a的随访及石蜡标本的S-P免疫组化法染色. 结果大肠癌MVD与其分化程度密切相关(P＜0.01);与临床病理分期(Dukes')间差异有显著意义(P＜0.05);与有无淋巴结、肝转移密切相关(P＜0.05);在术后复发与无复发生存者间差异有非常显著性意义(P＜0.01).增殖活性表达提示,分化愈差,有淋巴结或肝转移时,增殖活性增高,术后复发与无复发生存者之间,增殖活性差异有显著意义(P＜0.05).结论大肠癌MVD及PCNA与肿瘤的浸润、淋巴结及肝转移相关.手术时虽无明显转移,但MVD增高及PCNA活性增强,提示可能有潜在的转移存在.     

大肠癌组织血管内皮生长因子及其受体的表达与肿瘤血管生成的关系

目的探讨血管内皮生长因子(VEGF)及其受体(KDR)的表达与人大肠癌组织血管生成的关系.方法采用免疫组织化学SABC法观察了68例人大肠癌组织中的VEGF及KDR的定位与分布,并对血管进行染色及计数.结果68例大肠癌组织中VEGF表达阳性率为55.9%(38/68),阳性物质主要位于肿瘤细胞膜及胞浆KDR表达阳性率为45.6%(31/68),既可位于癌组织及癌组织旁的血管内皮细胞,又可位于肿瘤细胞胞膜及胞浆.VEGF表达与大肠Dukes分期密切相关.VEGF表达阳性大肠癌组织的微血管密度(MVD)(31.2±12.6)显著高于VEGF表达阴性(12.7±6.3)(P＜0.01),而且随着VEGF表达强度的增强,癌组织内微血管密度明显增加(P＜0.01).结论大肠癌细胞分泌的VEGF既可以旁分泌的形式促进肿瘤血管的生成,也可能存在着自分泌形式,VEGF与大肠癌的生长、浸泣和转移密切相关,是大肠癌主要的血管新生诱导因子之一,可促进大肠癌的血管生成.     

Expression of tissue factor and vascular endothelial growth factor is associated with angiogenesis in colorectal cancer

We examined the expression of tissue factor (TF) and vascular endothelial growth factor (VEGF) and the microvessel density (MVD) in 100 patients with colorectal cancer, and we investigated the relationship of the expression of TF or VEGF with angiogenesis. TF antigen was positive in 57.0% of all specimens. Incidence of TF expression was 41.2%, 45.5%, 52.6%, 84.6%, and 81.3% in tumors from patients in clinical stages I, II, IIIA, IIIB, and IV, respectively. TF expression was correlated with the Dukes' classification (P = 0.01) and the clinical stage of colorectal cancer (P = 0.02). VEGF antigen was positive in 64.0% of all specimens. Incidence of VEGF expression was 41.2%, 57.6%, 73.7%, 84.6%, and 75.0% in tumors from patients in clinical stages I, II, IIIA, IIIB, and IV, respectively. VEGF expression was correlated with the Dukes' classification (P = 0.01) but showed a weak association with the clinical stage (P = 0.08). MVD was significantly associated with the depth of invasion (P = 0.01), lymph node metastasis (P = 0.001), and liver metastasis (P = 0.02). The mean values of MVD were 7.5 +/- 2.8, 10.1 +/- 5.7, 14.6 +/- 5.8, 13.5 +/- 3.9, and 15.9 +/- 4.2 in tumors from patients in clinical stages I, II, IIIA, IIIB, and IV, respectively. A close relationship between VEGF and MVD (P < 0.001) and a significant correlation between TF expression and MVD were observed (P = 0.02). TF-positive carcinomas presented high MVD and VEGF expression (P < 0.001) more frequently than did TF-negative tumors. These results suggest that involvement of TF in the process of metastasis and progression of colorectal cancer may depend on increased angiogenesis.     

Correlation of integrin β3 mRNA and vascular endothelial growth factor protein expression profiles with the clinicopathological features and prognosis of gastric carcinoma

AIM： To investigate integrin β3 mRNA and vascular endothelial growth factor （VEGF） protein expression in gastric carcinoma, and its correlation with microvascular density, growth-pattern, invasion, metastasis and prognosis. METHODS： In situ hybridization（ISH） of integrin β3 mRNA and immunohistochemistry of VEGF and CD34 protein were performed on samples from 118 patients with gastric cancer. RESULTS： The positive rate of integrin β3 mRNA in non-tumor gastric mucosa （20%） was significantly lower than that of the gastric cancer tissue （52.5%, X^2 = 10.20, P 〈 0.01）. In patients of infiltrating type, stage T3-T4, vessel invasion, lymphatic metastasis, hepatic or peritoneal metastasis, the positive expression rates of integrin β3 mRNA were significantly higher than those in patients of expanding type （P 〈 0.01）, stage T1-T2 （P 〈 0.01）, non-vessel invasion （P 〈 0.01）, without lymphatic metastasis （P 〈 0.01）, without hepatic and peritoneal metastasis （P 〈 0.01）, respectively. In patients of infiltrating type, stage T3-T4, vessel invasion, lymphatic metastasis, hepatic or peritoneal metastasis, the positive expression rates of VEGF protein were significantly higher than those in patients of expanding type （P 〈 0.01）, stage T1-T2 （P 〈 0.01）, non-vessel invasion （P 〈 0.01）, without lymphatic metastasis （P 〈 0.01）, without hepatic and peritoneal metastasis （P 〈 0.01）, respectively. In patients of infiltrating type, stage T3-T4, vessel invasion, lymphatic metastasis, hepatic or peritoneal metastasis, the mean MVD were significantly higher than those in patients of expanding type （P 〈 0.01）, stage T1-T2 （P 〈 0.01）, non-vessel invasion （P 〈 0.01）, without lymphatic metastasis （P 〈 0.01）, without hepatic and peritoneal metastasis （P 〈 0.01）, respectively. It was found that the positive expression rate of integrin β3 mRNA was positively related to that of VEGF protein （P 〈 0.01） and MVD （P 〈 0.05）,     

Tnactivation of PTEN is associated with increased angiogenesis and VEGF overexpression in gastric cancer

AIM: To investigate the expression of PTEN/MMAC1/TEP1and vascular endothelial growth factor (VEGF), their roles in biologic behavior and angiogenesis and their association in gastric cancer.METHODS: Immunohistochemical staining was used to evaluate the expression of PTEN, VEGF and microvascular density (MVD) on paraffin-embedded sections in 70 patients with primary gastric cancer and 24 patients with chronic superficial gastritis (CSG). Expression of PTEN, VEGF and MVD were compared with clinicopathological features of gastric cancer. The relationship between expression of PTEN, VEGF and MVD as well as the relationship between PTEN and VEGF expression in caner cells were investigated.RESULTS: PTEN expression significantly decreased (t= 3.98,P＜0.01) whereas both VEGF expression and MVD significant increased (t = 4.29 and 4.41, respectively, both P＜0.01)in gastric cancer group compared with CSG group. PTEN expression was significantly down-regulated (t = 1.95,P＜0.05) whereas VEGF expression (t = 2.37, P＜0.05) and MVD (t = 3.28, P＜0.01) was significantly up-regulated in advanced gastric cancer compared with early-stage gastric cancer. PTEN expression in gastric cancer showed a negative association with lymph node metastasis (t= 3.91, P＜0.01),invasion depth (t= 1.95, P＜0.05) and age (t= 4.69, P＜0.01).MVD in PTEN-negative gastric cancer was significantly higher than that in PTEN-positive gastric cancer (t = 3.69,P＜0.01), and there was a negative correlation between PTEN expression and MVD (γ = -0.363, P＜0.05). VEGF expression was positively associated with invasion depth (especially with serosa invasion, t = 4.69, P＜0.01), lymph node metastasis (t= 2.31, P＜0.05) and TNM stage (t= 3.04,P＜0.01). MVD in VEGF-positive gastric cancer was significantly higher than that in VEGF-negative gastric cancer (t = 4.62,P＜0.01), and there was a positive correlation between VEGF expression of and MVD (γ = 0.512, P＜0.05). VEGF expression in PTEN-negative gastric cancer was significantly stronger than that in PTEN-positive gastric cancer (t = 2.61,P＜0.05), and there was a significantly negative correlation between the expression of VEGF and PTEN (γ = -0.403,P＜0.05).CONCLUSION: Our results imply that inactivation of PTEN gene and over-expression of VEGF contribute to the neovascularization and progression of gastric cancer. PTENrelated angiogenesis might be attributed to its up-regulation of VEGF expression. PTEN and VEGF could be used as the markers reflecting the biologic behaviors of tumor and viable targets in therapeutic approaches to inhibit angiogenesis of gastric cancers.     

大肠癌组织中血管内皮生长因子的表达及意义

目的 探讨血管内皮生长因子（ＶＥＧＦ）在大肠癌组织中的表达及其与大砀癌发展的关系。方法 应用名单组织化学ＬＳＡＢ法检测５２你人大肠癌组织的ＶＥＧＦ表达,分析ＶＥＧＦ与大肠癌组织类类型、分化程度、Ｄｕｋｅｓ分期及淋巴结转移毕率随关大肠癌Ｋｕｋｅｓ分期的进展而增加,且Ｄｕｋｅｓ Ｃ期的ＶＥＧＦ表达率与ＤｕｋｅｓＡ期相比有显著性差异（Ｐ〈０．０５）,ＶＥＧＦ在有淋巴结转移组的４０．００％（Ｐ〈０．０１）     

Relationship between expression of CD105 and growth factors in malignant tumors of gastrointestinal tract and its significance

AIM: Angiogenesis is an important step in the growth of solid malignant tumors. A number of angiogenic factors have been found such as transforming growth factorβ1 (TGF-β1)and vascular endothelial growth factor (VEGF). However,the roles of TGFβ1 and VEGF in gastrointestinal carcinogenesis are still unclear. This study was to investigate the expressions of TGF-β1 and VEGF in gastrointestinal tract malignant tumors, as well as their association with microvessel density (MVD). At the same time, we also observed the localization of TGF-β1 and its receptor CD105 in gastric malignant tumors.METHODS: The expressions of TGF-β1 and CDL05 were detected in 55 fresh specimens of gastric carcinoma and VEGF and CD105 in 44 fresh specimens of colorectal carcinoma by immunohistochemical staining (S-ABC). TGF-β1 and CD105 in 55 gastric carcinoma tissues on the same slide were detected by using double-stain Tmmunohistochemistry (DS-ABC).RESULTS: Among the 55 cases of gastric carcinoma tissues,30 were positive for TGF-β1 (54.55 %). The MVD of TGF-β1 strong positive group (++～+++ 23.22±5.8) was significantly higher than that of weak positive group (+17.56±7.2) and negative group (- 17.46±3.9) (q=4.5, q=5.3207, respectively,P＜0.01). In the areas of high expression of TGF-β1, MVD and the expression of CD105 were also high. Among the 44 cases of colonic carcinoma tissues, 26 were positive for VEGF (59.1%). The expressions of both VEGF and CD105 (MVD)were related with the depth of invasion (F=5.438, P＜0.05;F=4.168, P=0.05), lymph node metastasis (F=10.311, P＜0.01;F=20.282, P＜0.01) and Dukes stage (F=6.196, P＜0.01;F=10.274, P＜0.01), but not with histological grade (F=0.487,P＞0.05). There was a significant correlation between the expression of VEGF and CD105 (MVD) (r=0.720, P＜0.01).CONCLUSION: Over-expression of TGF-β1 and VEGF acts as stimulating factors of angiogenesis in gastrointestinal tumors.CD105, as a receptor of TGF-β1, can regulate the biological effect of TGF-β1 in tumor angiogenesis. MVD marked by CD105 is more suitable for detecting newborn blood vessels.     

Correlation of integrin β3 mRNA and vascular endothelial growth factor protein expression profiles with the clinicopathological features and prognosis of gastric carcinoma

AIM: To investigate integrin 133 mRNA and vascular endothelial growth factor (VEGF) protein expression in gastric carcinoma, and its correlation with microvascular density, growth-pattern, invasion, metastasis and prognosis. METHODS: In situ hybridization(ISH) of integrin β3 mRNA and immunohistochemistry of VEGF and CD34 protein were performed on samples from 118 patients with gastric cancer. RESULTS: The positive rate of integrin 133 mRNA in non- tumor gastric mucosa (20%) was significantly lower than that of the gastric cancer tissue (52.5%, x2 = 10.20, P ＜ 0.01). In patients of infiltrating type, stage T3-T4, vessel invasion, lymphatic metastasis, hepatic or peritoneal metastasis, the positive expression rates of integrin β3 mRNA were significantly higher than those in patients of expanding type (P ＜ 0.01), stage T1-T2 (P ＜ 0.01), non-vessel invasion (P ＜ 0.01), without lymphatic metastasis (P ＜ 0.01), without hepatic and peritoneal metastasis (P ＜ 0.01), respectively. In patients of infiltrating type, stage T3-T4, vessel invasion, lymphatic metastasis, hepatic or peritoneal metastasis, the positive expression rates of VEGF protein were significantly higher than those in patients of expanding type (P ＜ 0.01), stage T1-T2 (P ＜ 0.01), non-vessel invasion (P ＜ 0.01), without lymphatic metastasis (P ＜ 0.01), without hepatic and peritoneal metastasis (P ＜ 0.01), respectively. In patients of infiltrating type, stage T3-T4, vessel invasion, lymphatic metastasis, hepatic or peritoneal metastasis, the mean MVD were significantly higher than those in patients of expanding type (P ＜ 0.01), stage T1-T2 (P ＜ 0.01), non-vessel invasion (P ＜ 0.01), without lymphatic metastasis (P ＜ 0.01), without hepatic and peritoneal metastasis (P ＜ 0.01), respectively. It was found that the positive expression rate of integrin β3 mRNA was positively related to that of VEGF protein (P ＜ 0.01) and MVD (P ＜ 0.05), meanwhile the positive expression rate of VEGF protein was positively related to NVD (P ＜ 0.05). The mean survival period in patients with positive expression of integrin β3 mRNA and VEGF, and MVD ≥ 54.9/mm2 was significantly shorter than that in patients with negative expression of integrin β3 mRNA (P ＜ 0.05) and VEGF (P ＜ 0.01), and MVD ＜ 54.9/mm2 (P ＜ 0.01). Five-year survival rate in patients with positive expression of integrin β3 mRNA and VEGF, and MVD ≥ 54.9/mm2 was significantly lower than those with negative expression of integrin β3 mRNA (P ＜ 0.05), VEGF (P ＜ 0.05), and NVD ＜ 54.9/mm2 (P ＜ 0.01). CONCLUSION: Integrin β3 and VEGF expression can synergistically enhance tumor angiogenesis, and may play a crucial role in invasion and metastasis of gastric carcinoma. Therefore, they may be prognostic biomarkers and novel molecular therapeutic targets.     

Inactivation of PTEN is associated with increased angiogenesis and VEGF overexpression in gastric cancer

AIM: To investigate the expression of PTEN/MMAC1/TEP1 and vascular endothelial growth factor (VEGF), their roles in biologic behavior and angiogenesis and their association in gastric cancer.METHODS: Immunohistochemical staining was used to evaluate the expression of PTEN, VEGF and microvascular density (MVD) on paraffin-embedded sections in 70 patients with primary gastric cancer and 24 patients with chronic superficial gastritis (CSG). Expression of PTEN, VEGF and MVD were compared with clinicopathological features of gastric cancer. The relationship between expression of PTEN, VEGF and MVD as well as the relationship between PTEN and VEGF expression in caner cells were investigated. RESULTS: PTEN expression significantly decreased (t= 3.98, P&lt;0.01) whereas both VEGF expression and MVD significant increased (t = 4.29 and 4.41, respectively, both P&lt;0.01) in gastric cancer group compared with CSG group. PTEN expression was significantly down-regulated (t=1.95, P&lt;0.05) whereas VEGF expression (t = 2.37, P&lt;0.05) and MVD (t= 3.28, P&lt;0.01) was significantly up-regulated in advanced gastric cancer compared with early-stage gastric cancer. PTEN expression in gastric cancer showed a negative association with lymph node metastasis (t= 3.91, P&lt;0.01), invasion depth (t= 1.95, P&lt;0.05) and age (t= 4.69, P&lt;0.01). MVD in PTEN-negative gastric cancer was significantly higher than that in PTEN-positive gastric cancer (t=3.69, P&lt;0.01), and there was a negative correlation betweenPTEN expression and MVD (γ=-0.363, P&lt;0.05). VEGF expression was positively associated with invasion depth (especially with serosa invasion, t = 4.69, P&lt;0.01), lymph node metastasis (t= 2.31, P&lt;0.05) and TNM stage (t= 3.04, P&lt;0.01). MVD in VEGF-positive gaslyic cancer was significantly higher than that in VEGF-negative gastric cancer (t=4.62, P&lt;0.01), and there was a positive correlation between VEGF expression of and MVD (y = 0.512, P&lt;0.05). VEGF expression in PTEN-negative gaslyic cancer was significantly stronger than that in PTEN-positive gastric cancer (t=2.61, P&lt;0.05), and there was a significantly negative correlation between the expression of VEGF and PTEN (γ=-0.403, P&lt;0.05).CONCLUSION: Our results imply that inactivation of PTEN gene and over-expression of VEGF contribute to the neovascularization and progression of gastric cancer. PTEN-related angiogenesis might be attributed to its up-regulation of VEGF expression. PTEN and VEGF could be used as the markers reflecting the biologic behaviors of tumor and viable targets in therapeutic approaches to inhibit angiogenesis of gastric cancers.     

Prognostic significance of vascular endothelial growth factor expression and microvessel density in carcinoma of ampulla of Vater

BACKGROUND/AIMS: To investigate whether the expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD) are of prognostic significance in ampullary carcinoma. METHODOLOGY: Twenty-two resected tumor specimens from patients with ampullary carcinoma were immunohistochemically stained for VEGF and CD34 (surrogate for vessels) by streptavidin-peroxidase method. RESULTS: Expression of VEGF in tumor tissue was found in 50% of patients. The mean MVD for entire group was 26.4 +/- 12.8. A significantly higher MVD was observed in the tumors with positive VEGF expression (35.0 +/- 9.6) compared with that of negative VEGF expression (17.7 +/- 9.3) (p<0.01). The expression of VEGF and MVD were closely related lymph node status and tumor TNM stage. The positive expression rate of VEGF and the average MVD in patients with lymph node metastases were 85.7% and 33.1 +/- 10.8 respectively, which were significantly higher than those in patients without lymph node metastases (33.3% and 22.8 +/- 11.8 respectively) (p<0.05). The positive expression rate of VEGF and the average MVD in patients with stage III and were 75% and 36.3 +/- 8.4 respectively, which were significantly higher than those in patients with stage I (25% and 18.4 +/- 10.1 respectively) or stage II (50% and 23.8 +/- 13.4 respectively) (p<0.05). The Kaplan-Meier survival curves showed that the 3-year survival rate for patients with positive VEGF expression or a high MVD (9.1% and 10% respectively) were lower than those in patients with negative VEGF expression or a low MVD (63.64% and 58.33% respectively) (p<0.05). CONCLUSIONS: VEGF is positively correlated with MVD in ampullary carcinoma. VEGF and angiogenesis may play an important role in lymph node metastasis and progression of ampullary carcinoma. VEGF and MVD appear to be important prognostic predictor in patients with ampullary carcinoma.