title: Expression of Vascular Endothelial Growth Factor correlates with the advance of clinical osteosarcoma.
abstract: OBJECTIVE
  Osteosarcoma is the most common primary malignancy in orthopaedic surgery. Studies suggest that expression of VEGF and high vascularity within osteosarcoma may correlate with poor prognosis. The purpose of this study was to determine whether there was a correlation of VEGF expression with clinical tumour stage and metastasis.
  
  
  METHODS
  This retrospective case series examined 54 cases of osteosarcoma patients who were treated during a ten-year period. Relevant clinical information included age, gender, tumour location, stage, adjuvant therapy, morbidity, mortality, and tumour subtypes. The clinical information was analysed for correlation of VEGF expression and tumour prognosis. Tumour sections were examined by routine H&E and by immunohistochemistry for VEGF, CD31, and the oncogenes c-myc and c-fos.
  
  
  RESULTS
  There was a significantly positive correlation between VEGF expression and tumour stages among these cases (p < 0.01). The data also suggested a higher cancer recurrence and more frequent cases of remote metastasis in the high-VEGF group compared to the low-VEGF group. VEGF expression also positively associated with c-fos and c-myc expressions in the primary tumour sections.
  
  
  CONCLUSIONS
  The results of this study highlight the role of VEGF in angiogenesis and tumour burden. Data also suggest the influence of VEGF may associate with the elevations of c-fos and c-myc expression. The development of novel therapies to target the VEGF pathway in osteosarcoma may lead to improved survival.
authors.affiliation: University of Kansas School of Medicine-Wichita, Wichita, KS, USA.
authors.forename: John
authors.initials: J
authors.lastname: Lammli
authors.forename: Minyan
authors.initials: M
authors.lastname: Fan
authors.forename: Howard G
authors.initials: HG
authors.lastname: Rosenthal
authors.forename: Meghan
authors.initials: M
authors.lastname: Patni
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rinehart
authors.forename: Gerardo
authors.initials: G
authors.lastname: Vergara
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ablah
authors.forename: Paul H
authors.initials: PH
authors.lastname: Wooley
authors.forename: George
authors.initials: G
authors.lastname: Lucas
authors.forename: Shang-You
authors.initials: SY
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001859:Bone Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000378:metabolism; D012516:Osteosarcoma / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D011379:Prognosis; D016760:Proto-Oncogene Proteins c-fos / Q000378:metabolism; D016271:Proto-Oncogene Proteins c-myc / Q000378:metabolism; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D016760:Proto-Oncogene Proteins c-fos; D016271:Proto-Oncogene Proteins c-myc; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A