title: Long-term follow-up of immunocytochemical analysis of vascular endothelial growth factor (VEGF), and its two receptors, VEGF-R1 (Flt-1) and VEGF-R2 (Flk-1/KDR), in oesophagogastric cancer.
abstract: BACKGROUND
  The prognostic significance of immunocytochemical analysis of tumour vascular endothelial growth factor (VEGF) and its 2 receptors, VEGF-R1 and VEGF-R2, remains incompletely investigated in patients with oesophagogastric cancer.
  
  
  METHODS
  Patients undergoing surgical resection were prospectively recruited between February 1999 and August 2000. Immunocytochemical analysis of VEGF, VEGF-R1 (Flt-1) and VEGF-R2 (Flk-1/KDR) was undertaken using validated techniques. Patients were followed up over a 10-year period using the Northern Ireland Cancer Registry.
  
  
  RESULTS
  Sixty-one patients were recruited (male=45, 73.8%) with a median age of 66.0 years (range 39-83). Forty-seven (77.0%) adenocarcinomas and 14 (23.0%) squamous cell carcinomas were resected. UICC tumour staging was: stage I=14.7%, II=24.6%, III=54.1% and IV=6.6%. VEGF, VEGF-R1 and VEGF-R2 were over-expressed in tumour epithelial cells. VEGF-R2 expression was decreased in the presence of lymphovascular invasion and higher tumour grade. The 10-year survival rate was 19.7% (n=12) with a median follow-up of 808 (IQR 356-2313) days. On univariate analysis only lymphovascular invasion significantly predicted poor prognosis in this cohort (p=0.05).
  
  
  CONCLUSIONS
  VEGF, VEGF-R1 and VEGF-R2 were over-expressed in tumour epithelial cells. VEGF-R2 expression was decreased in the presence of more aggressive pathological variables. Larger studies are required to assess the prognostic significance of these biomarkers in oesophagogastric cancer.
authors.affiliation: Department of Upper Gastrointestinal Surgery, Ulster Hospital, Dundonald, Northern Ireland, United Kingdom. rgray05@qub.ac.uk
authors.forename: Ronan T
authors.initials: RT
authors.lastname: Gray
authors.forename: Mark E
authors.initials: ME
authors.lastname: O'Donnell
authors.forename: Perry
authors.initials: P
authors.lastname: Maxwell
authors.forename: James A
authors.initials: JA
authors.lastname: McGuigan
authors.forename: Gary M
authors.initials: GM
authors.lastname: Spence
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000378:metabolism*; D004938:Esophageal Neoplasms / Q000378:metabolism*; D004943:Esophagogastric Junction / Q000473:pathology; D004947:Esophagus / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000378:metabolism*; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000378:metabolism*
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1; D040301:Vascular Endothelial Growth Factor Receptor-2