Serum Vascular Endothelial Growth Factor (VEGF-C) as a Diagnostic and Prognostic Marker in Patients with Ovarian Cancer
Li Y (2013) Serum Vascular Endothelial Growth Factor (VEGF-C) as a Diagnostic and Prognostic Marker in Patients with Ovarian
Cancer. PLoS ONE 8(2): e55309. doi:10.1371/journal.pone.0055309
Serum Vascular Endothelial Growth Factor (VEGF-C) as a Diagnostic and Prognostic Marker in Patients with Ovarian Cancer
Daye Cheng 0
Bin Liang 0
Yunhui Li 0
Goli Samimi, Kinghorn Cancer Centre, Garvan Institute of Medical Research, Australia
0 1 Department of Transfusion, The First Hospital of China Medical University , Shenyang , China , 2 High Vocational Technological College, China Medical University , Shenyang , China , 3 Department of Clinical Laboratory, No.202 Hospital , Shenyang , China
VEGF-C is regarded as one of the most efficient factors in regulating lymphangiogenesis. The aim of this study was to better understand the role of VEGF-C in the progression of ovarian cancer and to assess its diagnostic and prognostic significance. A total of 109 patients with ovarian cancer, 76 patients with benign ovarian diseases, and 50 healthy controls were recruited in this study. Serum levels of VEGF-C were determined by ELISA method. The results showed that serum levels of VEGF-C were significantly higher in the patients with ovarian cancer than those with benign ovarian diseases and healthy controls (P,0.01). Serum level of VEGF-C was correlated with FIGO stage, lymph node metastasis, tumor resectability, and survival of the patients (P,0.05). The areas of receiver operating curves of VEGF-C were higher than those of CA125 in different screening groups. Analysis using the Kaplan-meier method indicated that patients with high VEGF-C had significantly shorter overall survival time than those with low VEGF-C (P,0.0001). In a multivariate analysis along with clinical prognostic parameters, serum VEGF-C was identified as an independent adverse prognostic variable for overall survival. These results indicated that serum VEGF-C may be a clinically useful indicator for diagnostic and prognostic evaluation in ovarian cancer patients.
-
Funding: This work was supported by a grant from the Liaoning Nature Science Fund (201102257). The funders had no role in study design, data collection and
analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Ovarian carcinoma is one of the most common cancers in
women and the leading cause of death of all gynecologic tumors.
In spite of recent advances, the prognosis for a woman diagnosed
with advanced-stage ovarian cancer has changed little over the last
thirty years with a five-year survival of only 30% [1,2]. The
relatively asymptomatic nature of early stage ovarian cancer, the
rapid progression of chemoresistant disease, and the high rate of
recurrence have earned ovarian cancer the reputation of being
a silent killer [3]. Tumor invasion and metastasis are the critical
steps in determining the aggressive phenotype of human cancers
and the major causes of cancer deaths. Although ovarian cancer
may spread in a variety of ways, dissemination to regional lymph
nodes via afferent lymphatics is an important step in ovarian
cancer metastasis and a major prognostic factor [4].
The vascular endothelial growth factor (VEGF) gene family,
which encodes five polypeptide growth factors, VEGF-A, -B, -C,
D, and placenta like growth factor (PLGF), is particularly
important because of its angiogenic and lymphangiogenic
properties that promote the growth and metastasis of neoplasms.
VEGF-C is regarded as the most efficient factor in regulating
lymphangiogenesis [5], and it has also been shown to directly
enhance the invasiveness of ovarian cancer cells in vitro [6]. To
date, high expression of VEGF-C is found in breast cancer,
prostatic cancer, gastric cancer, colon cancer, and lung cancer,
and is associated with lymphangiogenesis, lymph node metastasis,
and prognosis [5,710].
In the progression of ovarian cancer, predictive factors can be
used to gain insight into the response to a particular therapy, and
prognostic factors can be useful in making decisions concerning
patients who should receive adjuvant therapy. However, the
diagnostic and prognostic value of serum VEGF-C in ovarian
cancer is unknown. The aim of this study was to better understand
the role of VEGF-C in the progression and metastasis of ovarian
cancer, and to assess its prognostic significance.
Materials and Methods
Patients
The study included 109 consecutive ovarian cancer patients
(age: 61.5610.2 years), who were collected before surgery from
the Department of Gynecology, No. 202 Hospital between July,
1999 and Sep, 2001. Clinical characteristics of the patients were
given in Table 1. All patients were surgically staged in accordance
with the International Federation of Gynecology and Obstetrics
(FIGO) criteria. Patients who underwent preoperative
chemotherapy and radiotherapy were excluded. In addition, samples of 76
age-matched patients (...truncated)