title: Differences in vascular endothelial growth factor receptor expression and correlation with the degree of enhancement in medulloblastoma.
abstract: OBJECTIVE
  Vascular endothelial growth factor (VEGF) is the major proangiogenic factor in many solid tumors. Vascular endothelial growth factor receptor (VEGFR) is expressed in abundance in pediatric patients with medulloblastoma and is associated with tumor metastasis, poor prognosis, and proliferation. Gadolinium enhancement on MRI has been suggested to have prognostic significance for some tumors. The association of VEGF/VEGFR and Gd enhancement in medulloblastoma has never been closely examined. The authors therefore sought to evaluate whether Gd-enhancing medulloblastomas have higher levels of VEGFR and CD31. Outcomes and survival in patients with enhancing and nonenhancing tumors were also compared.
  
  
  METHODS
  A retrospective analysis of patients with enhancing, nonenhancing, and partially enhancing medulloblastomas was performed. Primary end points included risk stratification, extent of resection, and perioperative complications. A cohort of 3 enhancing and 3 nonenhancing tumors was selected for VEGFR and CD31 analysis as well as microvessel density measurements.
  
  
  RESULTS
  Fifty-eight patients were analyzed, and 20.7% of the medulloblastomas in these patients were nonenhancing. Enhancing medulloblastomas exhibited strong VEGFR1/2 and CD31 expression relative to nonenhancing tumors. There was no significant difference in perioperative complications or patient survival between the 2 groups.
  
  
  CONCLUSIONS
  These results suggest that in patients with medulloblastoma the presence of enhancement on MRI may correlate with increased vascularity and angiogenesis, but does not correlate with worse patient prognosis in the short or long term.
authors.affiliation: Departments of Neurosurgery.
authors.forename: Shawn L
authors.initials: SL
authors.lastname: Hervey-Jumper
authors.forename: Hugh J L
authors.initials: HJ
authors.lastname: Garton
authors.forename: Darryl
authors.initials: D
authors.lastname: Lau
authors.forename: David
authors.initials: D
authors.lastname: Altshuler
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Quint
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Robertson
authors.forename: Karin M
authors.initials: KM
authors.lastname: Muraszko
authors.forename: Cormac O
authors.initials: CO
authors.lastname: Maher
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis*; D002528:Cerebellar Neoplasms / Q000737:chemistry* / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008527:Medulloblastoma / Q000737:chemistry* / Q000473:pathology / Q000601:surgery*; D008833:Microcirculation; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction; D040262:Receptors, Vascular Endothelial Growth Factor / Q000032:analysis*; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D003287:Contrast Media; D019408:Platelet Endothelial Cell Adhesion Molecule-1; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D005682:Gadolinium; D040262:Receptors, Vascular Endothelial Growth Factor
keywords: CD31; HPRT = hypoxanthine phosphoribosyltransferase; RT-PCR = reverse transcription-polymerase chain reaction; VEGF; VEGF = vascular endothelial growth factor; VEGFR = VEGF receptor; hpf = high-powered field; medulloblastoma; oncology; tumor enhancement