Serum vascular endothelial growth factor C correlates with lymph node metastases and high-risk tumor profiles in papillary thyroid carcinoma.
OBJECTIVE
To evaluate the clinical relevance of serum vascular endothelial growth factor (VEGF) and VEGF-C in papillary thyroid carcinoma (PTC).


BACKGROUND
VEGF is a potent angiogenic factor promoting tumor angioinvasion and distant metastases, whereas VEGF-C enhances nodal metastases because of its lymphangiogenic effect. Although both tissues VEGF and VEGF-C have been shown to contribute to tumor metastases in PTC, the clinical relevance of serum VEGF (sVEGF) and sVEGF-C remains unknown.


METHODS
Preoperative serum samples collected from 85 primary PTC patients and 44 control subjects with benign thyroid diseases were measured for sVEGF and sVEGF-C levels. Potential correlations between their serum levels and clinicopathologic features as well as the commonly adopted risk group stratification profiles of the tumors were analyzed.


RESULTS
Preoperative sVEGF and sVEGF-C levels of PTC patients were significantly higher compared with those of control subjects (P = 0.001 and P < 0.001, respectively). sVEGF-C level was significantly elevated in older patients, those with extrathyroidal invasion and with lymph node metastases whereas sVEGF level was significantly increased in multifocal tumors. sVEGF-C, but not sVEGF, correlated significantly with high risk tumors in all commonly adopted risk group stratification profiles. An elevated preoperative sVEGF-C level of >7200 pg/mL was shown to be the only independent risk factor for nodal metastases. sVEGF-C levels declined significantly at 3 months after thyroidectomy in PTC but not control patients.


CONCLUSIONS
sVEGF-C levels in PTC patients correlated significantly with the presence of nodal metastases and advanced tumor stages. Its clinical relevance needs further evaluation.
Yu
Xiao-Min
XM
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
Lo
Chung-Yau
CY
Lam
Alfred King-Yin
AK
Leung
Pauline
P
Luk
John M
JM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000097:blood* / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013959:Thyroid Diseases / Q000097:blood; D013964:Thyroid Neoplasms / Q000097:blood* / Q000601:surgery; D013965:Thyroidectomy; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D042582:Vascular Endothelial Growth Factor C / Q000097:blood*
D042461:Vascular Endothelial Growth Factor A; D042582:Vascular Endothelial Growth Factor C