Abstract
The aim of this study was to evaluate the expression of vascular endothelial growth factor (VEGF)-C and -D in pancreatic cancer and to reveal its relation to lymph node metastasis. Formalin-fixed, paraffin-embedded blocks were obtained from 58 patients with pancreatic head cancer. All of the patients underwent a curative resection. The total number of resected lymph nodes was 1,058. The expressions of VEGF-C and -D were evaluated by immunohistochemical staining. To evaluate the relation to lymph node metastasis, the expressions of VEGF-C and -D between the marginal and central portions in the tumor were compared. When >25% of the tumor cells showed distinct staining, the portion was judged as high expression. The two groups with high expression of VEGF-C (P = 0.015) and VEGF-D (P = 0.020) in the marginal portion had a significantly higher incidence of lymph node metastasis compared with the groups with low expression, respectively. Furthermore, the group with high expression of both VEGF-C and -D in the marginal portion had a higher incidence of lymph node metastasis compared with the group with low expression (P = 0.007). The 5-year survival rate of patients with high expression of both VEGF-C and -D in the marginal portion was significantly lower than that of patients with low expression of both VEGF-C and -D (P = 0.017). VEGF-C and -D expression in tumor cells in the marginal portion of the tumor significantly associated with lymphatic metastasis and prognosis in patients with pancreatic head cancer.
Highlights
The survival of patients with adenocarcinoma of the pancreas is worse than that with any other gastrointestinal malignancy [1]
The two groups with high expression of vascular endothelial growth factor (VEGF)-C (P ؍0.015) and VEGF-D (P ؍0.020) in the marginal portion had a significantly higher incidence of lymph node metastasis compared with the groups with low expression, respectively
The group with high expression of both VEGF-C and -D in the marginal portion had a higher incidence of lymph node metastasis compared with the group with low expression (P ؍0.007)
Summary
The survival of patients with adenocarcinoma of the pancreas is worse than that with any other gastrointestinal malignancy [1]. The presence or absence of lymph node metastasis is one of the important prognostic factors for patients with pancreatic cancer. Studies of the lymphatic system have been overshadowed by the greater emphasis placed on the blood vascular system, recent studies have promoted the importance of the lymphatic system by the discovery of several molecules that act as markers of the lymphatic endothelium. These include molecules such as lymphatic vessel endothelial hyaluronan receptor-1, Prox-1, Podoplanin, and vascular endothelial growth factor receptor (VEGFR)-3 [2,3,4,5]. Vascular endothelial growth factor (VEGF)-C and -D, which are members of VEGF family, have been reported as lymphatic-specific growth factors [6, 7]
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