title: Plasma level of transforming growth factor beta1 measured from the azygos vein predicts prognosis in patients with esophageal cancer.
abstract: OBJECTIVE
  Transforming growth factor (TGF)-beta regulates cell growth inhibition. When tumor cells lose their sensitivity to TGF-beta growth inhibition, the excess TGF-beta that results may act on tumor cells to facilitate tumor development. Previously, we have shown that an elevated systemic TGF-beta 1 level is not related to tumor progression in esophageal cancer (Y. Fukai et al., Int J Cancer 2003;104:161-6). We considered that systemic inflammation or chronic disease, in addition to the tumor, may influence the plasma TGF-beta level. Therefore, we examined the hypothesis that the plasma TGF-beta level measured from the azygos vein would independently predict tumor progression and prognosis in patients with esophageal cancer.
  
  
  METHODS
  Fifty-seven plasma samples were obtained intraoperatively from the azygos vein in patients with esophageal cancer. ELISA was used to quantify the plasma TGF-beta 1 levels, which were correlated with pathological features and patient survival.
  
  
  RESULTS
  The mean plasma TGF-beta 1 level measured from the azygos vein of esophageal cancer patients was 5.09 +/- 0.48 ng/ml (mean +/- SE). The survival rates of patients with a high TGF-beta 1 level (defined as a level above the 4.6 ng/ml level of normal controls) in the azygos vein were significantly lower than those of patients with a low TGF-beta 1 level (P = 0.0317). Moreover, the TGF-beta 1 level in the azygos vein was an independent prognostic factor for overall survival (P = 0.0474).
  
  
  CONCLUSIONS
  The level of plasma TGF-beta 1 measured from the azygos vein is an independent predictor in patients with esophageal cancer and may reflect tumor progression more specifically because the azygos vein is responsible for venous return from the esophagus.
authors.affiliation: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan. mfukuchi@med.gunma-u.ac.jp
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fukai
authors.forename: Masanobu
authors.initials: M
authors.lastname: Nakajima
authors.forename: Makoto
authors.initials: M
authors.lastname: Sohda
authors.forename: Norihiro
authors.initials: N
authors.lastname: Masuda
authors.forename: Ryokuhei
authors.initials: R
authors.lastname: Manda
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Tsukada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000328:Adult; D000368:Aged; D001401:Azygos Vein / Q000378:metabolism*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D004938:Esophageal Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D016212:Transforming Growth Factor beta / Q000097:blood*; D053773:Transforming Growth Factor beta1; D016896:Treatment Outcome
chemical_list: C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1