title: Increased expression of the vascular endothelial growth factor is a pejorative prognosis marker in papillary thyroid carcinoma.
abstract: Vascular endothelial growth factor (VEGF) is a potent stimulator of endothelial cell proliferation. It has been implicated in tumor growth of human thyroid carcinomas. Using the VEGF immunohistochemistry staining score, we correlated the level of VEGF expression with the metastatic spread of 19 cases of thyroid papillary carcinoma. The VEGF immunostaining score, ranging from 0-9, was determined as the multiplication of a percentage of labeled thyrocytes score (0, no labeling; 1, <30%; 2, 31--60%; 3, >61% of labeled thyrocytes) and an intensity score (0, no staining; 1, weak; 2, mild; 3, strong staining). The mean score +/- SD was 5.74 +/- 2.59 for all carcinomas. The mean score for metastatic papillary carcinoma was 8.25 +/- 1.13 vs. 3.91 +/- 1.5 for nonmetastatic papillary cancers (P < 0.001). By discriminant analysis, we found a threshold value of 6.0, with a sensitivity of 100% and a specificity of 87.5%. There were no statistical differences between metastatic and nonmetastatic carcinomas when age, tumor size, or thyroglobulin levels were considered. The VEGF immunostaining score seems to be a helpful marker for metastasis spread in differentiated thyroid cancers. An increased production of VEGF could assess an aggressive disease and be the hallmark of a trend to produce metastasis. We propose the VEGF immunostaining score as a marker for the prognosis in differentiated thyroid cancers. A value of 6 or more, should be considered as at high risk for metastasis threat, prompting the physician to institute a tight follow up of the patient.
authors.affiliation: Department of Endocrinology, Centre Hospitalier et Universitaire de Nancy, 54500 Vandoeuvre-les-Nancy, France. marc.olivier.klein@free.fr
authors.forename: M
authors.initials: M
authors.lastname: Klein
authors.forename: J M
authors.initials: JM
authors.lastname: Vignaud
authors.forename: V
authors.initials: V
authors.lastname: Hennequin
authors.forename: B
authors.initials: B
authors.lastname: Toussaint
authors.forename: L
authors.initials: L
authors.lastname: Bresler
authors.forename: F
authors.initials: F
authors.lastname: Plénat
authors.forename: J
authors.initials: J
authors.lastname: Leclère
authors.forename: A
authors.initials: A
authors.lastname: Duprez
authors.forename: G
authors.initials: G
authors.lastname: Weryha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D016002:Discriminant Analysis; D016228:Endothelial Growth Factors / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008222:Lymphokines / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013974:Thyroxine / Q000097:blood; D013997:Time Factors; 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; D013954:Thyroglobulin; D013974:Thyroxine