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Volume 146, Issue 5, Pages 896-905 (November 2009)


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Vascular endothelial growth factor-D is correlated with hepatic metastasis from gastric cancer after radical gastrectomy

Jingyu Deng, MDa, Han Liang, MDaCorresponding Author Informationemail address, Dan Sun, MSb, Yi Pan, MDc, Baogui Wang, MDa, Yuhong Guo, MDc

Accepted 30 April 2009. published online 27 July 2009.

Background

Vascular endothelial growth factor-D (VEGF-D), the activating ligand for vascular endothelial growth factor receptor-3 (VEGFR-3), has been identified as an important endogenic tumor-associated lymphangiogenic factors which can promote lymphatic metastasis from primary tumor. Lymphatic metastasis, which is the most common metastatic method of gastric cancer (GC), is still deemed a potentially relative indicator of distant metastasis from GC. We hypothesize that VEGF-D is associated with hepatic metastasis (HM) from GC after radical gastrectomy by promoting lymphatic metastasis and/or hematogenous metastasis.

Methods

This study included 150 GC patients who underwent radical gastrectomy (75 cases presented with HM and 75 cases presented without any recurrences). VEGF-D, VEGF-C, VEGF-A, VEGFR-2, VEGFR-3, and microvessel density (MVD) were evaluated by immunohistochemistry. Besides, clinicopathologic variables and prognosis of GC patients were analyzed statistically.

Results

Significant associations were seen between Lauren classification and HM, VEGF-D and HM, VEGFR-3 and HM, MVD and HM, and between nodal status and HM. VEGF-D remained an independent factor for HM from GC after radical gastrectomy. Further significant association was evaluated between high-grade VEGF-D expression and short disease-free survival of HM from GC after radical gastrectomy.

Conclusion

VEGF-D, which can induce lymphangiogenesis specifically in many kinds of malignant diseases, is an important factor for predicting HM from GC following radical gastrectomy.

a Department of Gastric Cancer Surgery, City Key Laboratory of Tianjin Cancer Center, Tianjin Medical University General Hospital, Tianjin, China

b Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China

c Department of Pathology, Tianjin Medical University General Hospital, Tianjin, China

Corresponding Author InformationReprint requests: Han Liang, MD, Gastric Oncology Division, Tianjin Medical University Cancer Hospital and City Key Laboratory of Tianjin Cancer Center, Tianjin, China.

PII: S0039-6060(09)00299-2

doi:10.1016/j.surg.2009.04.025


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