Invited commentary

Abstract

Increased tumor neovascularization (angiogenesis) has been associated with a worse prognosis in patients with surgically resectable non–small cell lung cancer. Tumor angiogenesis appears to be necessary for tumor growth and plays a critical role in the development of metastases. The authors attempted to clarify the role of mast cells in the promotion of tumor angiogenesis by examining the mast cell number, the microvessel density, and vascular endothelial growth factor expression in paraffin-embedded tumor sections from patients with non-small cell lung cancer. Their results demonstrated a significant correlation between mast cell count and microvessel density. However, there was no association between vascular endothelial growth factor (VEGF) expression and mast cell count. From these results the authors concluded that mast cells may play a role in enhancing tumor angiogenesis in lung cancer by a mechanism independent of VEGF.Although the authors demonstrated a significant correlation between mast cell counts and microvessel counts, the precise contribution that mast cells make to the development of tumor angiogenesis is not answered by this study. The authors correctly state that the increased microvessel density itself may allow for the nonspecific infiltration of a greater number of mast cells into the tumor. It will be important for future studies to accurately define the role of mast cells in tumor angiogenesis before therapies directed against mast cells or their products are considered as adjuvant therapy in the treatment of patients with non-small cell lung cancer. Increased tumor neovascularization (angiogenesis) has been associated with a worse prognosis in patients with surgically resectable non–small cell lung cancer. Tumor angiogenesis appears to be necessary for tumor growth and plays a critical role in the development of metastases. The authors attempted to clarify the role of mast cells in the promotion of tumor angiogenesis by examining the mast cell number, the microvessel density, and vascular endothelial growth factor expression in paraffin-embedded tumor sections from patients with non-small cell lung cancer. Their results demonstrated a significant correlation between mast cell count and microvessel density. However, there was no association between vascular endothelial growth factor (VEGF) expression and mast cell count. From these results the authors concluded that mast cells may play a role in enhancing tumor angiogenesis in lung cancer by a mechanism independent of VEGF. Although the authors demonstrated a significant correlation between mast cell counts and microvessel counts, the precise contribution that mast cells make to the development of tumor angiogenesis is not answered by this study. The authors correctly state that the increased microvessel density itself may allow for the nonspecific infiltration of a greater number of mast cells into the tumor. It will be important for future studies to accurately define the role of mast cells in tumor angiogenesis before therapies directed against mast cells or their products are considered as adjuvant therapy in the treatment of patients with non-small cell lung cancer.