engleski

Correlation between vascular endothelial growth factor expression and angiogenesis in renal cell carcinoma

To analyze the immunohistochemical pattern of vascular endothelial growth factor (VEGF) expression, to investigate angiogenesis by average microvessel density (MVD) in clear cell renal cell carcinoma (CCRCC) and to correlate tumor angiogenic properties to clinicopathologic parameters. Surgical specimens of 93 CCRCC (62 men and 31 women) were examined by immunohistochemistry using CD31 to visualize endothelial cells, pAb for VEGF expression and MIB-1 for assessing Ki 67 proliferative index. Characteristics of VEGF expression was recorded as percentage of positive tumor cells as low (0-75% VEGF positive cells) and high (76-100 % VEGF positive cells), VEGF cytoplasmic distribution and VEGF histological pattern. All features of VEGF expression were correlated with MVD, Ki 67 proliferative index and clinicopathological parameters. There were 74 tumors in pT1 and pT2 stage and 19 in pT3 and pT4. Statistical significant difference was found between groups of tumors with low and high VEGF expression regarding MVD (p<0.05), nuclear grade (p<0.01) and Ki 67 proliferation index (p<0.01). Such difference was found between tumors with homogenous and heterogeneous VEGF expression in relation to pT stage, size of tumor and nuclear grade (for all parameters p<0.05). Tumors with the high VEGF expression and heterogeneous pathohistologic distribution were bigger, with higher nuclear grade and proliferative index and with less number of blood vessels. There were significant difference between diffuse and perimembranous cytoplasmic VEGF expression. Diffuse VEGF expression was in relation with higher pT stage and nuclear grade (p<0.01). Ki 67 proliferation index was connected significantly with pT stage (p<0.01) and nuclear grade (p<0.05). This tumor model did not confirm the simple postulated relation between VEGF overexpression and angiogenesis through high microvessel count, but the character of VEGF expression showed significant correlation to worse histologic prognostic factors.

carcinoma; renal cell; CD31; VEGF; survival rate

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