The prognostic significance of angiogenesis and the effect of vascular endothelial growth factor on angiogenic process in Wilms' tumour.
OBJECTIVE
There is a subgroup of patients with Wilms' tumour (WT) having favourable clinicopathological features but adverse outcome. We aimed to investigate the prognostic significance of angiogenesis and whether it can be used for predicting which patients will fall into this category, and the possible role of vascular endothelial growth factor (VEGF) on angiogenesis in WT.


METHODS
Tumours in nephrectomy specimens from 63 WT patients were investigated for neovascularisation and VEGF expression by immunohistochemistry. The endothelial cells were highlighted by anti-CD34 and anti-CD31, and the microvessels in the hot-spots were counted. Correlations between the microvessel density (MVD), VEGF expression, clinicopathological features and prognosis were studied.


RESULTS
Among 21 patients with follow-up data, favourable histology was detected in 17, seven of which died of disease. Patients with highly vascular tumours showed significantly poorer prognosis than those with low vascular tumours. There was no significant relationship between angiogenesis and VEGF expression. VEGF immunostaining revealed various patterns in different components of WT.


CONCLUSIONS
We suggest that high MVD can be used as an indicator of poor prognosis with WT patients displaying favourable histology and there might be some additional growth factors other than VEGF which may also be responsible for angiogenesis in WTs.
Ozluk
Yasemin
Y
Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Turkey. yasozluk@hotmail.com
Kilicaslan
Isin
I
Gulluoglu
Mine G
MG
Ayan
Inci
I
Uysal
Veli
V
D018952:Antigens, CD34 / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D007668:Kidney / Q000098:blood supply; D007680:Kidney Neoplasms / Q000098:blood supply / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008833:Microcirculation / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000378:metabolism*; D009392:Nephrectomy; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D011379:Prognosis; D015996:Survival Rate; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D009396:Wilms Tumor / Q000098:blood supply / Q000378:metabolism* / Q000401:mortality
D018952:Antigens, CD34; D019408:Platelet Endothelial Cell Adhesion Molecule-1; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A