title: Angiogenesis and lymphangiogenesis in stage 1 germ cell tumours of the testis.
abstract: OBJECTIVE
  To determine whether angiogenesis can be used as an additional prognostic indicator in patients with stage 1 germ cell tumours of the testis.
  
  
  METHODS
  Paraffin sections were assessed immunohistochemically from 51 patients with clinical stage 1 germ cell tumours of the testis (28 seminoma, 23 teratoma) treated by orchidectomy and surveillance only. Sections were analysed for microvascular density (MVD), and expression of the angiogenic factors vascular endothelial growth factor (VEGF) and thymidine phosphorylase (TP). In addition, in the seminoma cases the presence of mRNA for the lymphangiogenic factor VEGF-C was examined by in situ hybridization, and its corresponding receptor VEGFR-3 by immunohistochemistry.
  
  
  RESULTS
  Teratoma specimens had a significantly higher mean (range) MVD (85, 26-163; P < 0.01) than both seminoma (37, 16-91) and four normal specimens (26, 18-30). Teratoma specimens also had significantly higher VEGF expression than both seminoma and normal specimens (P < 0.01). Despite these differences between groups, and indeed individual tumours, there was no significant correlation between MVD and VEGF, or between either MVD or VEGF and relapse-free survival. TP expression was significantly greater in tumours than in normal specimens (P < 0.02) but with very little inter-tumour variation. VEGF-C mRNA and VEGFR-3 protein were detected in a third to a half of cases, with expression mostly around endothelial vessels.
  
  
  CONCLUSIONS
  The marked differences between normal testis and tumours implicate angiogenesis in the biology of germ cell tumours of the testis. In addition, the detection of factors involved in lymphangiogenesis in some seminomas, tumours which initially metastasize primarily to lymph nodes, indicate that although not prognostic in this study, further studies are warranted in both these areas in the search for further prognostic indicators and therapeutic targets.
authors.affiliation: Molecular Oncology Unit, ICRF, Institute of Molecular Medicine, Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, UK.
authors.forename: A
authors.initials: A
authors.lastname: Jones
authors.forename: C
authors.initials: C
authors.lastname: Fujiyama
authors.forename: K
authors.initials: K
authors.lastname: Turner
authors.forename: S
authors.initials: S
authors.lastname: Fuggle
authors.forename: D
authors.initials: D
authors.lastname: Cranston
authors.forename: H
authors.initials: H
authors.lastname: Turley
authors.forename: R
authors.initials: R
authors.lastname: Valtola
authors.forename: R
authors.initials: R
authors.lastname: Bicknell
authors.forename: A L
authors.initials: AL
authors.lastname: Harris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D016228:Endothelial Growth Factors / Q000378:metabolism; D018237:Germinoma / Q000098:blood supply* / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008222:Lymphokines / Q000378:metabolism; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D013736:Testicular Neoplasms / Q000098:blood supply* / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
chemical_list: D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors