Abstract
Gallbladder carcinoma (GBC) is the most common cancer of the biliary tract. Lymph node metastasis (LNM) is the major diffusion route of GBC and is a prognosis factor. The aim of study was to assess the potential of the serum VEGF-C and VEGF-D (sVEGF-C/D) levels to predict the presence of LNM and the survival of GBC patients. The preoperative sVEGF-C/D levels of 31 patients with GBC, 10 patients with cholesterol polyps, and 10 healthy volunteers were measured by enzyme-linked immunoadsorbent assay (ELISA). The sVEGF-C/D levels of patients with GBC were significantly higher than those of people with healthy gallbladders (p < 0.001 and p = 0.001, respectively) and cholesterol polyp (p = 0.032 and p = 0.004, respectively). In GBC, the sVEGF-C levels were associated with LNM (p = 0.011), distant metastasis (p = 0.018), and stage (p = 0.045), but the sVEGF-D levels had a significant association with the tumor depth (p = 0.001), LNM (p = 0.001), distant metastasis (p = 0.047), and stage (p = 0.002). The sVEGF-C/D diagnostic values for the presence of GBC were sensitivity of 71.0 and 74.2 % and specificity of 80.0 and 85.0 %, respectively. With respect to the diagnosis of LNM, the diagnostic values of sVEGF-C/D were as follows: sensitivity 81.2 and 87.5 % and specificity 73.3 and 80.0 %, respectively. The mean survival time with high sVEGF-C was significantly shorter than that with low sVEGF-C (p < 0.001), which was also true for low sVEGF-D (p = 0.032). The preoperative sVEGF-C/D levels might be reliable biomarkers for the presence of disease and LNM in patients with GBC. The sVEGF-C/D levels may be prognosis factors that can predict a poor outcome for GBC patients.
Highlights
Gallbladder carcinoma (GBC) is the sixth most common cancer of the gastrointestinal tract and is most common cancer of the biliary tract [1]
The sVEGF-C/D levels in the patient group In GBC patients, the mean sVEGF-C levels and median sVEGF-D levels were significantly higher than the healthy group (7669.58±2012.00 vs 4951.55±1963.48 pg/ml; p
Association between the clinicopathological feature and the sVEGF-C/D levels of GBC (Table 1) The sVEGF-C levels were associated with Lymph node metastasis (LNM), distant metastasis, and stage (p=0.011, p=0.018 and p=0.045, respectively)
Summary
Gallbladder carcinoma (GBC) is the sixth most common cancer of the gastrointestinal tract and is most common cancer of the biliary tract [1]. The incidence rates are extraordinarily high in Asia and relatively high in Korea (13.7/100,000). The 5-year survival rate is only 5 %, and the overall mean survival time is 6 months [2]. Radical resection is the most effective and only potentially curative treatment [3, 4]. Because there are few effective diagnostic measures and classical symptoms, most of patients with GBC are treated at late stages of the disease, resulting in a poor overall prognosis [5]. Lymph node metastasis (LNM) is the major diffusion route of GBC. It is an important component of tumor staging and a prognostic factor for GBC. LNM often occurs in the early stage of GBC.
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