title: VEGF-C and VEGF-A synergistically enhance lymph node metastasis of gastric cancer.
abstract: OBJECTIVE
  Vascular endothelial growth factor C (VEGF-C) is the most important molecule in lymphangiogenesis and its relationship with lymph node metastasis has attracted considerable interest. We investigated the relationship of VEGF-C or VEGF-A with clinicopathological factors in gastric cancer patients.
  
  
  METHODS
  Eighty gastric cancer patients who underwent gastric resection were analyzed immunohistochemically for expression of VEGF-C and VEGF-A protein.
  
  
  RESULTS
  Positive immunoreactivity of VEGF-C and VEGF-A was observed in 75 (93.8%) and 41 (51.3%) patients, respectively. VEGF-A expression was significantly correlated with tumor differentiation (p=0.0017) and vascular invasion (p=0.0004). And positive relationship of VEGF-C expression was only demonstrated with tumor differentiation (p=0.0168). Interestingly, however, the frequency of lymph node metastasis was significantly higher in the patients with expression of both VEGF-C and VEGF-A (strong positive expression, p=0.036). Furthermore, the expression of both was also significantly correlated with depth of tumor invasion, tumor differentiation, lymphatic invasion, and vascular invasion.
  
  
  CONCLUSIONS
  The present results suggest that strong expression of VEGF-A in addition to VEGF-C expression is essential in lymph node metastasis, presumably because enhanced metastatic potential including lymphangiogenesis induced by both VEGF-A and VEGF-C is vital in lymph node metastasis of gastric cancer.
authors.affiliation: Second Department of Surgery, Hamamatsu University School of Medicine, Japan. kenji@hama-med.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Kondo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kaneko
authors.forename: Megumi
authors.initials: M
authors.lastname: Baba
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D042582:Vascular Endothelial Growth Factor C / Q000378:metabolism*
chemical_list: D042461:Vascular Endothelial Growth Factor A; D042582:Vascular Endothelial Growth Factor C