title: Vascular endothelial growth factor-C expression in bladder transitional cell cancer and its relationship to lymph node metastasis.
abstract: OBJECTIVE
  To elucidate the role of vascular endothelial growth factor-C (VEGF-C) in bladder transitional cell carcinoma (TCC), examining VEGF-C expression in bladder TCC tissue and the association of VEGF-C with clinicopathological features, as the expression of VEGF-C in several carcinomas is significantly associated with angiogenesis, lymphangiogenesis and regional lymph node metastasis, but there are few reports of VEGF-C expression in bladder TCC.
  
  
  METHODS
  The study included 45 patients with bladder TCC; VEGF-C expression was assessed by immunohistochemistry and the association between VEGF-C expression and angiogenesis, as evaluated by microvessel density (MVD), was examined.
  
  
  RESULTS
  There was VEGF-C expression in the cytoplasm of tumour cells, but very little in the normal transitional epithelium. VEGF-C expression was significantly associated with tumour size, pathological T stage, pathological grade, lymphatic-venous involvement and pelvic lymph node metastasis (all P < 0.05). Multivariate analysis showed that VEGF-C expression was an exclusive independent factor influencing pelvic lymph node metastasis. Moreover, the patients with high VEGF-C expression had a markedly poorer prognosis than those with no or low VEGF-C expression (P = 0.014). A multivariate analysis based on the Cox proportional hazard model showed that lymph node metastasis was only an independent prognostic factor in the multivariate analysis using the Cox regression model (P = 0.010).
  
  
  CONCLUSIONS
  The present study provides evidence supporting the involvement of VEGF-C expression in the promotion of lymph node metastasis in bladder TCC. Examination of VEGF-C expression in biopsy specimens might be beneficial in predicting pelvic lymph node metastasis.
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, Changsha city, Hunan province, China.
authors.forename: Xiongbing
authors.initials: X
authors.lastname: Zu
authors.forename: Zhengyan
authors.initials: Z
authors.lastname: Tang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Ning
authors.initials: N
authors.lastname: Gao
authors.forename: Jian
authors.initials: J
authors.lastname: Ding
authors.forename: Lin
authors.initials: L
authors.lastname: Qi
mesh_terms: D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000473:pathology*; D018572:Disease-Free Survival; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000473:pathology*; D042582:Vascular Endothelial Growth Factor C / Q000378:metabolism*
chemical_list: D042582:Vascular Endothelial Growth Factor C