Tumor angiogenesis in predicting the survival of patients with stage I lung cancer.
OBJECTIVE
The effects of angiogenesis on survival were assessed by measuring the tumor microvessel density and vascular endothelial growth factor expression in patients with resected stage I non-small cell lung carcinoma.


METHODS
The study population included 141 patients who underwent complete resection for stage pT1 and T2 N0 M0 tumors between 1999 and 2007. Lobectomy and pneumonectomy were performed in 131 and 10 patients, respectively. Tumor specimens were analyzed immunohistochemically for staining with anti-CD105 antibody to determine tumor microvessel density and anti-vascular endothelial growth factor antibody to determine the vascular endothelial growth factor expression level. Univariate and multivariate analyses were performed for factors influencing patients' survival.


RESULTS
The overall 5-year survival was calculated as 68%, with rates of 76.9% for patients with T1 disease and 66.2% for patients with T2 disease (P = .4). The vascular endothelial growth factor expression rate was 94.3% for patients with stage I non-small cell lung carcinoma. Vascular endothelial growth factor expression did not influence survival (P = .9). The median microvessel density of the tumors measured based on the level of CD105 expression was 19.8. The effect of microvessel density on survival was significant (P = .02). The 5-year survivals of patients with tumors with 20 or more microvessels and less than 20 microvessels were 76.8% and 56.1%, respectively; this difference was highly significant (P = .004). The microvessel density was determined as an independent factor influencing survival on multivariate analysis (P = .03).


CONCLUSIONS
The level of vascular endothelial growth factor expression in tumors was not a successful predictor of survival in patients with resected stage I non-small cell lung carcinoma. A high microvessel density based on CD105 is a strong predictor of prognosis in these patients.
Medetoglu
Baris
B
Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
Gunluoglu
Mehmet Zeki
MZ
Demir
Adalet
A
Melek
Huseyin
H
Buyukpinarbasili
Nur
N
Fener
Neslihan
N
Dincer
Seyyit Ibrahim
SI
D015703:Antigens, CD / Q000032:analysis; D002289:Carcinoma, Non-Small-Cell Lung / Q000098:blood supply* / Q000737:chemistry / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D000071063:Endoglin; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000098:blood supply* / Q000737:chemistry / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D055806:Microvessels / Q000737:chemistry / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000401:mortality* / Q000473:pathology*; D011013:Pneumonectomy; D016016:Proportional Hazards Models; D011956:Receptors, Cell Surface / Q000032:analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
D015703:Antigens, CD; C064206:ENG protein, human; D000071063:Endoglin; D011956:Receptors, Cell Surface; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A