title: Expression of vascular endothelial growth factor C correlates with lymphatic vessel density and prognosis in human gastroesophageal junction carcinoma.
abstract: BACKGROUND
  The present study clarifies the clinical significance of vascular endothelial growth factor C (VEGF-C) in patients with gastroesophageal junction carcinoma treated with curative resection, as well as the correlation between VEGF-C expression and lymphatic vessel density (LVD).
  
  
  METHODS
  VEGF-C expression was immunohistochemically detected in 128 patients with gastroesophageal junction carcinoma, who underwent curative surgical resection. The mean optical density (MOD) was measured to represent the expression level of VEGF-C. The lymphatic vessels were labeled with D2-40 to calculate LVD. The association between MOD and LVD and clinicopathological parameters as well as the prognosis were analyzed.
  
  
  RESULTS
  Both VEGF-C expression and LVD were correlated with nodal metastasis and clinical stage (p < 0.05). For the high (MOD > 0.18) and low (MOD ≤ 0.18) VEGF-C group, the mean LVD was 16.9 ± 5.96 and 13.6 ± 5.58, respectively (p = 0.002), and the mean number of positive resected lymph nodes was 2.9 ± 2.44 and 2.0 ± 2.36, respectively (p = 0.025). For the high (LVD > 13) and low (LVD ≤ 13) LVD group, the mean number of positive resected lymph nodes was 3.0 ± 2.34 and 1.9 ± 2.43, respectively (p = 0.010). In univariate analysis, both high expression of VEGF-C and a high LVD level were statistically associated with poor disease-free survival (p = 0.000). Multivariate analysis showed that VEGF-C, nodal metastasis, depth of tumor invasion, postoperative chemotherapy, and resection extent were independent survival predictors (p < 0.05).
  
  
  CONCLUSIONS
  Increased expression of VEGF-C is correlated with high levels of LVD and poorer treatment outcome.
authors.affiliation: Department of Radiotherapy, Cancer Hospital, Shantou, PR China.
authors.forename: Li Ping
authors.initials: LP
authors.lastname: Yang
authors.forename: Lin Chen
authors.initials: LC
authors.lastname: Fu
authors.forename: Hong
authors.initials: H
authors.lastname: Guo
authors.forename: Liang Xi
authors.initials: LX
authors.lastname: Xie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D004943:Esophagogastric Junction / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D042601:Lymphatic Vessels / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D042582:Vascular Endothelial Growth Factor C / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D042582:Vascular Endothelial Growth Factor C