title: Vascular endothelial growth factor expression and microvessel density--two useful tools for the assessment of prognosis and survival in gastric cancer patients.
abstract: OBJECTIVE
  The role of angiogenesis in progression and metastasis of gastric cancer has been studied over the last years. The aim of our study was to assess the microvessel density and vascular endothelial growth factor (VEGF) expression in correlation with prognosis, survival and the risk for upper gastrointestinal (GI) bleeding as well.
  
  
  METHODS
  We prospectively assessed angiogenesis in 40 patients with gastric carcinoma. Microvessel density was calculated using CD31 and CD34 markers, and VEGF expression was assessed in biopsy samples. The tumor stage was established using imaging methods: CT scan for M and N stage and endoscopic ultrasound for T and N stages. The correlation between pathological markers and tumor stage, survival rate and risk of upper gastrointestinal bleeding was assessed.
  
  
  RESULTS
  The study included 40 patients with gastric cancer; among them 8 patients presented with upper GI bleeding. The average microvessel density was 10.21 for CD31 and 11.85 for CD34 in all patients VEGF was positive only in 45% of patients. The microvessel density was higher in patients with advanced TNM stage, and a correlation with the risk of UGIB and survival rate was also found. VEGF expression correlated with TNM stage and with the risk of upper GI bleeding.
  
  
  CONCLUSIONS
  Microvessel density (estimated by CD34) was involved in locally advanced disease, while VEGF was correlated with loco-regional extension and distant metastasis in gastric cancer patients. There was a clear correlation between angiogenic parameters, survival rate and the risk of upper GI bleeding.
authors.affiliation: Department of Gastroenterology; University of Medicine and Pharmacy, Petru Rares Str. No. 2, Craiova, Romania. sevastita@gmail.com
authors.forename: Sevastita
authors.initials: S
authors.lastname: Iordache
authors.forename: Adrian
authors.initials: A
authors.lastname: Saftoiu
authors.forename: Claudia Valentina
authors.initials: CV
authors.lastname: Georgescu
authors.forename: Sandu
authors.initials: S
authors.lastname: Ramboiu
authors.forename: Dan Ionut
authors.initials: DI
authors.lastname: Gheonea
authors.forename: Monalisa
authors.initials: M
authors.lastname: Filip
authors.forename: Michael
authors.initials: M
authors.lastname: Schenker
authors.forename: Tudorel
authors.initials: T
authors.lastname: Ciurea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000032:analysis; D001706:Biopsy; D002277:Carcinoma / Q000098:blood supply* / Q000737:chemistry / Q000150:complications / Q000401:mortality / Q000556:secondary; D019160:Endosonography; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D055806:Microvessels / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000098:blood supply* / Q000737:chemistry / Q000150:complications / Q000401:mortality / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
chemical_list: D018952:Antigens, CD34; D019408:Platelet Endothelial Cell Adhesion Molecule-1; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A