Abstract
Background. Vascular endothelial growth factor (VEGF) induces proliferation of endothelial cells,
stimulates angiogenesis, and increases vascular permeability. Increased VEGF expression
has been associated with poor clinical outcomes in many malignancies. Several recent
reports have documented over expression of VEGF in papillary thyroid cancer. We hypothesized
that increased expression of VEGF would be associated with either an increased risk
of recurrence or a decreased recurrence-free survival in papillary thyroid cancer.
Methods. Immunohistochemistry was used to detect VEGF expression in archival paraffin-embedded
surgical thyroid specimens from 96 subjects with papillary thyroid cancer. Results. VEGF expression was detected in 98% (94/96) of the samples, predominantly of slight-to-moderate
intensity in the majority of malignant cells. However, the specific finding of a diffuse
pattern of intense immunostaining for VEGF was detected significantly more often than
less intense, patchy immunostaining patterns in subjects with distant metastasis at
diagnosis (63% versus 15%, P =.005), local recurrence (58% versus 13%, P =.001), and distant recurrence (83% versus 14%, P =.001). Furthermore, this specific pattern of diffuse, intense VEGF expression was
associated with a significantly shorter recurrence-free survival than other staining
patterns (P =.007). Conclusions. These data demonstrate that the immunohistochemical pattern of VEGF staining in the
initial surgical specimen is strongly associated with the incidence of local and distant
metastasis in papillary thyroid cancer. (Surgery 2001;129:552-8.)
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Article info
Publication history
Accepted:
May 26,
2000
Footnotes
*Reprint requests: R. Michael Tuttle, MD, Endocrinology Service, Memorial Sloan-Kettering Cancer Center, Box 419 (H-715) 1275 York Ave, New York, NY 10021.
**Surgery 2001;129:552-8.
Identification
Copyright
© 2001 Mosby, Inc. Published by Elsevier Inc. All rights reserved.