Neoangiogenesis in Patients with Gastric Carcinoma in Relation to the Expression of Vascular Endothelial Growth Factor and Thymidine Phosphorylase

Abstract

Background: We investigated the prognostic significance of microvessel density and the relationship between the expression of vascular endothelial growth factor (VEGF) and thymidine phosphorylase (TP), and angiogenesis in patients with gastric carcinoma. Materials and Methods: The expression of VEGF and TP, and the microvessel density were examined by immunohistochemistry in patients with gastric carcinoma invading the serosa. Results: The prognosis of patients with low microvessel density in the cancerous tissue was significantly better than that of patients with high microvessel density. A multivariate analysis showed that microvessel density, lymph node metastasis and tumor size were independent prognostic indicators. VEGF was expressed in tumor cells and TP was expressed in both tumor cells and infiltrating cells. VEGF expression in tumor cells and TP expression in infiltrating cells significantly correlated with microvessel density. However, microvessel density was not correlated with TP expression in tumor cells. Combined analysis based on VEGF expression in tumor cells and TP expression in infiltrating cells revealed that microvessel density was the highest in VEGF-positive and TP-positive tumors and the lowest in VEGF-negative and TP-negative tumors. Microvessel density is an independent prognostic indicator in patients with gastric carcinoma invading the serosa. Conclusion: VEGF expression in tumor cells and TP expression in infiltrating cells may indicate the microvessel density.