Prognostic value of vascular endothelial growth factor expression in gastric carcinoma

BACKGROUND. Many studies have shown that angiogenesis plays an important role in the growth, progression, and metastasis of solid tumors. Recently, several angiogenic factors have been identified. Vascular endothelial growth factor (VEGF) is thought to be one such angiogenic factor and is also thought to be a selective mitogen for endothelial cells. We investigated the correlation between the expression of VEGF and the progression of gastric carcinoma. METHODS. One hundred twenty‐nine specimens resected from patients with gastric carcinoma were investigated by staining with a polyclonal antibody against VEGF. Correlations between the expression of VEGF, microvessel density, and various clinicopathologic factors were studied. RESULTS. Microvessel density, determined by immunostaining for Factor VIII related antigen, was significantly higher in VEGF‐positive tumors than in VEGF‐negative tumors. VEGF positivity was correlated with vessel involvement, lymph node metastasis, and liver metastasis. Moreover, patients with VEGF‐positive tumors had a significantly poorer prognosis than those with VEGF‐negative tumors. Multivariate analysis indicated that the expression of VEGF is an independent prognostic factor in patients with gastric cancer. According to the mode of recurrence, the frequency of hepatic metastases was significantly increased among patients with VEGF‐positive tumors. CONCLUSIONS. The expression of VEGF may be a good prognostic indicator for patients with gastric carcinoma and may also be useful as a predictor of the mode of recurrence in patients with gastric carcinoma. Cancer 1996;77:858‐63.