Vascular endothelial growth factor-D is an independent prognostic factor in epithelial ovarian carcinoma |
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Authors: | Yokoyama Y Charnock-Jones D S Licence D Yanaihara A Hastings J M Holland C M Emoto M Umemoto M Sakamoto T Sato S Mizunuma H Smith S K |
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Affiliation: | Department of Obstetrics and Gynaecology, University of Cambridge, The Rose Maternity Hospital, UK. yokoyama@cc.hirosaki-u.ac.jp |
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Abstract: | We assessed the presence of vascular endothelial growth factor (VEGF)-C, VEGF-D and their receptor VEGFR-3 by immunohistochemistry in 59 epithelial ovarian carcinomas, 11 borderline tumours and 20 benign cystadenomas. VEGF-C and VEGF-D were generally expressed in tumour cells and also in endothelia adjacent to tumour nests which showed a strong staining for them. VEGFR-3 was expressed in lymphatic and vascular endothelial cells adjacent to tumour nests. Immunoreactivity was significantly more frequent as lesions progressed from a benign tumour to advanced carcinoma. A strong correlation was found between VEGF-C and VEGF-D detected in carcinoma and VEGFR-3 detected in neighbouring endothelial cells. Increased expression of VEGF-C, VEGF-D and VEGFR-3 was significantly associated with lymph node metastasis and peritoneal metastasis outside the pelvis. There was a significant correlation between the high levels of VEGF-C and VEGF-D proteins, and poor survival. The presence of VEGF-D was an independent prognostic indicator by multivariate analysis. We conclude that VEGF-C, VEGF-D and VEGFR-3 play an important role in lymphatic spread and intraperitoneal tumour development in ovarian carcinoma. Since VEGF-D was found to be an independent predictor of poor outcome, its measurement, together with other prognostic markers may improve prospective identification of patients with a poor prognosis. |
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Keywords: | VEGF-C VEGF-D VEGFR-3 epithelial ovarian carcinoma prognosis lymph node metastasis |
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