title: Vascular endothelial growth factor C: the predicator of early recurrence in patients with N2 non-small-cell lung cancer.
abstract: OBJECTIVE
  Mediastinal lymph node metastasis (N2) is a key prognostic factor for lung carcinoma. This study was undertaken to investigate the relationship between vascular endothelial growth factor C (VEGF-C) expression and postoperative early recurrence in patients with N2 non-small-cell lung cancer.
  
  
  METHODS
  Cancer tissue samples from 92 patients with pN2 non-small-cell lung cancer and benign lung disease tissues samples from 30 patients were examined by reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry assays to detect VEGF-C expression. The difference of VEGF-C expression was compared by chi(2) test. All patients with N2 disease were evaluated within 1 year after surgery to detect early tumour recurrence. Cox regression analysis was performed to determine the risk factors of postoperative early recurrence of N2 lung cancer.
  
  
  RESULTS
  VEGF-C mRNA expression was observed in 64 (70%) pN2 lung cancer tissues, but was not found in benign lung disease tissues. Early recurrence occurred in 43 patients (47%) at 1 year after operation. The main pattern was distant recurrence, and the most frequent sites were the brain and lung. The early recurrence rate in patients with positive VEGF-C expression was significantly higher than that of those with negative VEGF-C expression (P=0.006, log-rank test). Cox regression analysis revealed that positive VEGF-C expression in tumours (hazard ratio (HR)=2.523, P=0.037) was an independent risk factor of postoperative early recurrence of N2 lung cancer.
  
  
  CONCLUSIONS
  VEGF-C expression was high in N2 lung cancer, with significant correlation to postoperative early recurrence. About one-half of the patients with N2 non-small-cell lung cancer would develop recurrence disease within 1 year after surgery, frequently with mediastinal nodes, brain or lung metastases. VEGF-C might be a predictor of postoperative early recurrence in patients with N2 non-small-cell lung cancer.
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, 324 Jing Wu Road, Jinan 250021, PR China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.forename: Xiang-Yan
authors.initials: XY
authors.lastname: Liu
authors.forename: Zhou
authors.initials: Z
authors.lastname: Wang
authors.forename: Fan-Ying
authors.initials: FY
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000096:biosynthesis* / Q000235:genetics; D001932:Brain Neoplasms / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000556:secondary / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics; D012334:RNA, Neoplasm / Q000235:genetics; D018714:Radiotherapy, Adjuvant; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D042582:Vascular Endothelial Growth Factor C / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; D012333:RNA, Messenger; D012334:RNA, Neoplasm; C467486:VEGFC protein, human; D042582:Vascular Endothelial Growth Factor C