title: Vascular endothelial growth factor-D is correlated with hepatic metastasis from gastric cancer after radical gastrectomy.
abstract: BACKGROUND
  Vascular endothelial growth factor-D (VEGF-D), the activating ligand for vascular endothelial growth factor receptor-3 (VEGFR-3), has been identified as an important endogenic tumor-associated lymphangiogenic factors which can promote lymphatic metastasis from primary tumor. Lymphatic metastasis, which is the most common metastatic method of gastric cancer (GC), is still deemed a potentially relative indicator of distant metastasis from GC. We hypothesize that VEGF-D is associated with hepatic metastasis (HM) from GC after radical gastrectomy by promoting lymphatic metastasis and/or hematogenous metastasis.
  
  
  METHODS
  This study included 150 GC patients who underwent radical gastrectomy (75 cases presented with HM and 75 cases presented without any recurrences). VEGF-D, VEGF-C, VEGF-A, VEGFR-2, VEGFR-3, and microvessel density (MVD) were evaluated by immunohistochemistry. Besides, clinicopathologic variables and prognosis of GC patients were analyzed statistically.
  
  
  RESULTS
  Significant associations were seen between Lauren classification and HM, VEGF-D and HM, VEGFR-3 and HM, MVD and HM, and between nodal status and HM. VEGF-D remained an independent factor for HM from GC after radical gastrectomy. Further significant association was evaluated between high-grade VEGF-D expression and short disease-free survival of HM from GC after radical gastrectomy.
  
  
  CONCLUSIONS
  VEGF-D, which can induce lymphangiogenesis specifically in many kinds of malignant diseases, is an important factor for predicting HM from GC following radical gastrectomy.
authors.affiliation: Department of Gastric Cancer Surgery, City Key Laboratory of Tianjin Cancer Center, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Jingyu
authors.initials: J
authors.lastname: Deng
authors.forename: Han
authors.initials: H
authors.lastname: Liang
authors.forename: Dan
authors.initials: D
authors.lastname: Sun
authors.forename: Yi
authors.initials: Y
authors.lastname: Pan
authors.forename: Baogui
authors.initials: B
authors.lastname: Wang
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D002277:Carcinoma / Q000378:metabolism / Q000556:secondary*; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology*; D042643:Vascular Endothelial Growth Factor D / Q000378:metabolism*; D040321:Vascular Endothelial Growth Factor Receptor-3 / Q000378:metabolism*
chemical_list: D018952:Antigens, CD34; D042643:Vascular Endothelial Growth Factor D; D040321:Vascular Endothelial Growth Factor Receptor-3