title: Microvascular density and hypoxia-inducible factor pathway in pancreatic endocrine tumours: negative correlation of microvascular density and VEGF expression with tumour progression.
abstract: Tumour-associated angiogenesis is partly regulated by the hypoxia-inducible factor (HIF) pathway. Endocrine tumours are highly vascularised and the molecular mechanisms of their angiogenesis are not fully delineated. The aim of this study is to evaluate angiogenesis and expression of HIF-related molecules in a series of patients with pancreatic endocrine tumours (PETs). The expression of vascular endothelial growth factor (VEGF), HIF-1alpha, HIF-2alpha and carbonic anhydrase 9 (CA9) was examined by immunohistochemistry in 45 patients with PETs and compared to microvascular density (MVD), endothelial proliferation, tumour stage and survival. Microvascular density was very high in PETs and associated with a low endothelial index of proliferation. Microvascular density was significantly higher in benign PETs than in PETs of uncertain prognosis, well-differentiated and poorly differentiated carcinomas (mean values: 535, 436, 252 and 45 vessels mm(-2), respectively, P < 0.0001). Well-differentiated tumours had high cytoplasmic VEGF and HIF-1alpha expression. Poorly differentiated carcinomas were associated with nuclear HIF-1alpha and membranous CA9 expression. Low MVD (P = 0.0001) and membranous CA9 expression (P = 0.0004) were associated with a poorer survival. Contrary to other types of cancer, PETs are highly vascularised, but poorly angiogenic tumours. As they progress, VEGF expression is lost and MVD significantly decreases. The regulation of HIF signalling appears to be specific in pancreatic endocrine tumours.
authors.affiliation: Department of Pathology, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110 Clichy, France. anne.couvelard@bjn.ap-hop-paris.fr
authors.forename: A
authors.initials: A
authors.lastname: Couvelard
authors.forename: D
authors.initials: D
authors.lastname: O'Toole
authors.forename: H
authors.initials: H
authors.lastname: Turley
authors.forename: R
authors.initials: R
authors.lastname: Leek
authors.forename: A
authors.initials: A
authors.lastname: Sauvanet
authors.forename: C
authors.initials: C
authors.lastname: Degott
authors.forename: P
authors.initials: P
authors.lastname: Ruszniewski
authors.forename: J
authors.initials: J
authors.lastname: Belghiti
authors.forename: A L
authors.initials: AL
authors.lastname: Harris
authors.forename: K
authors.initials: K
authors.lastname: Gatter
authors.forename: F
authors.initials: F
authors.lastname: Pezzella
mesh_terms: D007516:Adenoma, Islet Cell / Q000098:blood supply* / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D000328:Adult; D051792:Basic Helix-Loop-Helix Proteins; D002256:Carbonic Anhydrases / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D008297:Male; D008833:Microcirculation; D009389:Neovascularization, Pathologic; D010190:Pancreatic Neoplasms / Q000098:blood supply* / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D014157:Transcription Factors / Q000378:metabolism; D042442:Vascular Endothelial Growth Factors / Q000378:metabolism*; D000099162:Endothelial PAS Domain-Containing Protein 1
chemical_list: D051792:Basic Helix-Loop-Helix Proteins; D002256:Carbonic Anhydrases; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D014157:Transcription Factors; D042442:Vascular Endothelial Growth Factors; D000099162:Endothelial PAS Domain-Containing Protein 1; C497442:HIF1A protein, human