Abstract
VEGF-C is regarded as one of the most efficient factors in regulating lymphangiogenesis. The aim of this study was to better understand the role of VEGF-C in the progression of ovarian cancer and to assess its diagnostic and prognostic significance. A total of 109 patients with ovarian cancer, 76 patients with benign ovarian diseases, and 50 healthy controls were recruited in this study. Serum levels of VEGF-C were determined by ELISA method. The results showed that serum levels of VEGF-C were significantly higher in the patients with ovarian cancer than those with benign ovarian diseases and healthy controls (P<0.01). Serum level of VEGF-C was correlated with FIGO stage, lymph node metastasis, tumor resectability, and survival of the patients (P<0.05). The areas of receiver operating curves of VEGF-C were higher than those of CA125 in different screening groups. Analysis using the Kaplan-meier method indicated that patients with high VEGF-C had significantly shorter overall survival time than those with low VEGF-C (P<0.0001). In a multivariate analysis along with clinical prognostic parameters, serum VEGF-C was identified as an independent adverse prognostic variable for overall survival. These results indicated that serum VEGF-C may be a clinically useful indicator for diagnostic and prognostic evaluation in ovarian cancer patients.
Highlights
Ovarian carcinoma is one of the most common cancers in women and the leading cause of death of all gynecologic tumors
Previous studies have demonstrated that vascular endothelial growth factor (VEGF)-C/ VEGFR3 signaling system is regarded as the most efficient pathway in regulating lymphangiogenesis
Vascular Endothelial Growth Factor (VEGF-C) secreted by tumor cells can act on receptor VEGFR-3 at the surface of lymphatic endothelial cells, activating the signaling system for tumor lymphangiogenesis
Summary
Ovarian carcinoma is one of the most common cancers in women and the leading cause of death of all gynecologic tumors. Tumor invasion and metastasis are the critical steps in determining the aggressive phenotype of human cancers and the major causes of cancer deaths. Ovarian cancer may spread in a variety of ways, dissemination to regional lymph nodes via afferent lymphatics is an important step in ovarian cancer metastasis and a major prognostic factor [4]. VEGF-C is regarded as the most efficient factor in regulating lymphangiogenesis [5], and it has been shown to directly enhance the invasiveness of ovarian cancer cells in vitro [6]. High expression of VEGF-C is found in breast cancer, prostatic cancer, gastric cancer, colon cancer, and lung cancer, and is associated with lymphangiogenesis, lymph node metastasis, and prognosis [5,7,8,9,10]
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