VEGF, HIF-1 alpha and CD34 expressions in gastric tumors (tms): Relationship with pathological factors and prognostic impact on survival

Abstract

4040 Background: We planned to investigate the prognostic impact of VEGF, HIF-1alpha, CD34 in gastric cancer patients (pts). Methods: We reviewed the medical records of 51 gastric cancer pts who had total or subtotal gastrectomy at Marmara University Hospital between 1999–2004 retrospectively. We evaluated the expression of VEGF, HIF-1alpha, CD34 by immunhistochemistry in the archival tumor tissues. Cytoplasmic staining was considered as positive for VEGF. The intensity of expression is scored between 0–4+ for HIF 1 alpha. CD 34 which represents microvessel density, was scored numerically based on the intensity of staining in endothelial cells. We recorded the clinical and pathological characteristics of these patients and analyzed their survival outcome. Results: Thirty out of 51 pts were male. The median age was 63(34–81). The median follow-up was 17 months. Thirty-six pts had node positive disease. Five pts had T1, 24 pts had T2, 19 pts had T3 and 3 pts had T4 disease. Vascular and lymphatic invasion were present in 57% and 77% tumors respectively. The 5-years OS was 45% and 5-year gastric cancer specific survival was 51%. VEGF was positive in 65% of tms, HIF 1alpha was positive (from 1+ to 4+) in 71% of tms. The median CD34 staining score was 19 (3–68). In univariate analyses, the expressions of VEGF, HIF 1 alpha and CD34 were more frequent in tms without serosal invasion (p=0.018, p=0.012, p=0.003 respectively).The expression patterns of VEGF, HIF-1α, CD34 were closely linked to each other; CD34 expression was significantly more frequent in tms with VEGF and HIF-1 alpha expression (p=0.000, p=0.000). HIF-1alpha expression was more frequent in tms with VEGF expression (p=0.000). The expressions of VEGF, HIF1alpha, CD34 and other pathological characteristics were shown to have no impact on survival in the multivariate analysis. Conclusions: Angiogenesis is an early event in carcinogenesis and plays an important role in tumor growth. In line with this information, the expression of VEGF, HIF1 alpha and CD 34 were more common in tms without serosal invasion. As a future perspective, biological agents targeting VEGF, HIF1 alpha might be more effective at earlier stages of gastric cancer No significant financial relationships to disclose.