title: Prognostic correlation of basic fibroblast growth factor and vascular endothelial growth factor in 1307 primary breast cancers.
abstract: This study was designed to investigate the possible relationship between the protein expression of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) with p53 status, breast cancer prognostic factors, metastatic site, and survival after adjuvant therapy. Basic fibroblast growth factor and VEGF expression were determined by enzyme-linked immunosorbent assays in cytosol specimens obtained from 1307 patients with T1-3 primary breast cancer (789 node-negative, 518 node-positive) diagnosed between 1990 and 1997. The median follow-up time was 70 months. Increased bFGF expression was more frequently found in tumors with low VEGF expression (r = -0.286; P = 0.095). Increased bFGF was associated with smaller tumors (P < 0.001), absence of axillary metastasis (P = 0.003), low S-phase fraction (P < 0.001), and longer recurrence-free survival (RFS; P = 0.0038) and overall survival (OS; P = 0.0316). Vascular endothelial growth factor was a prognostic factor for RFS (P < 0.0001) and OS (P < 0.0001) in univariate and multivariate analyses (RFS: 95% CI, 1.1-1.7; P = 0.036; OS: 95% CI, 1.2-2.2; P = 0.002), whereas bFGF expression was not correlated with RFS or OS. Increased VEGF content was correlated with shorter survival after adjuvant endocrine therapy (RFS, P = 0.0004; OS, P = 0.0009). Patients with estrogen receptor-negative disease were excluded from the analysis. Basic fibroblast growth factor was not a prognostic factor after adjuvant systemic therapy, nor was it related to metastatic site. Expression of VEGF is an independent prognostic factor for patients with primary breast cancer. High bFGF expression was related to good prognostic features and longer survival times, but did not add prognostic information in multivariate analysis. The results might implicate that different angiogenic pathways exist in human breast cancer.
authors.affiliation: Department of Oncology, Radiumhemmet, Karolinska Institute and Hospital, SE-161 67 Stockholm, Sweden. barbro.linderholm@cck.ki.se
authors.forename: Barbro K
authors.initials: BK
authors.lastname: Linderholm
authors.forename: Birgitta
authors.initials: B
authors.lastname: Lindh
authors.forename: Lars
authors.initials: L
authors.lastname: Beckman
authors.forename: Martin
authors.initials: M
authors.lastname: Erlanson
authors.forename: Kent
authors.initials: K
authors.lastname: Edin
authors.forename: Bjorn
authors.initials: B
authors.lastname: Travelin
authors.forename: Jonas
authors.initials: J
authors.lastname: Bergh
authors.forename: Kjell
authors.initials: K
authors.lastname: Grankvist
authors.forename: Roger
authors.initials: R
authors.lastname: Henriksson
mesh_terms: D001943:Breast Neoplasms / Q000235:genetics / Q000378:metabolism*; D018270:Carcinoma, Ductal, Breast / Q000235:genetics / Q000378:metabolism*; D018275:Carcinoma, Lobular / Q000235:genetics / Q000378:metabolism*; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000096:biosynthesis* / Q000235:genetics; D016158:Genes, p53 / Q000235:genetics; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D016019:Survival Analysis; D042461:Vascular Endothelial Growth Factor A / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D042461:Vascular Endothelial Growth Factor A; D016222:Fibroblast Growth Factor 2