Coexpression of heparanase, basic fibroblast growth factor and vascular endothelial growth factor in human esophageal carcinomas

Heparan sulfate (HS), which is degraded by heparanase, plays an important role in cell adhesion, insolubility of the extracellular matrix (ECM) and as a reservoir for various growth factors such as basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF). In the present study, we examined the immunohistochemical expression of heparanase, bFGF and VEGF, and evaluated the correlation between their expression and microvessel density (MVD) in human esophageal carcinomas. Heparanase, bFGF and VEGF were immunolocalized predominantly to the carcinoma cells, but they were also localized to the endothelial cells of microvessels near the carcinoma cell nests. In carcinomas with invasion of the muscular layer or adventitia, heparanase staining was stronger at the invasive areas of carcinomas than the intraepithelial spread. Expression of heparanase and bFGF and the degree of MVD were associated with tumor invasion, lymph node metastasis and pathological stages. Cases with positive staining for heparanase, bFGF or VEGF tended to have a higher MVD than those without staining, and carcinomas with concomitant expression of heparanase, bFGF and VEGF showed the highest MVD. The level of heparanase mRNA expression was directly correlated with the MVD. In addition, heparanase-positive cases had a higher positive ratio of bFGF and VEGF compared with the heparanase-negative cases. These data suggest the possibility that heparanase may contribute to not only cancer cell invasion but also angiogenesis probably through degradation of HS in the ECM and release of bFGF and VEGF from the HS-containing ECM.     

HER2 is unlikely to be involved in directly regulating angiogenesis in human breast cancer.

Angiogenesis is a fundamental component of oncogenesis. Angiogenic factors such as vascular endothelial growth factor (VEGF) and platelet derived-endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) are generated from tumor cells to provide tumor growth and are thought to be regulated via the HER2 oncogene, whose amplification is the most common genetic alteration in breast cancer. The present study aimed to evaluate the immunoreactivity of angiogenic factors (VEGF, PD-ECGF/TP) and microvessel density (MVD) via epidermal growth factor receptor (EGFR) and HER2, and to correlate their expression with clinicopathologic features. Two hundred one invasive human breast cancer specimens were tested immunohistochemically for the expression of these proteins. In addition, MVD was examined using computerized image analysis. VEGF could be an additional interesting prognostic variable, as it was significantly associated with tumor grade (P=0.002), stage (P=0.018), and negative estrogen receptor status (P=0.011). EGFR was significantly related to invasive ductal carcinoma (P=0.030), tumor grade (P=0.009), VEGF expression (P=0.013), PD-ECGF/TP expression (P=0.024), and MVD (P=0.050). The finding that VEGF is not correlated to MVD does not rule out a crucial role of VEGF as a key factor in angiogenesis. HER2 could not be correlated to MVD, VEGF expression, or PD-ECGF/TP expression, indicating that this factor is unlikely to be involved in directly regulating angiogenesis, whereas the significant correlations between EGFR and histologic tumor type, tumor grade, the angiogenic factors VEGF and PD-ECGF/TP, and MVD point out that EGF is the major modulating growth factor for angiogenesis in breast cancer.     

血管内皮细胞生长因子和血管生成与胃癌发展的关系

目的探讨血管内皮细胞生长因子（ＶＥＧＦ）和血管生成与胃癌发展的关系。方法应用免疫组织化学和原位分子杂交技术,检测５６例人胃癌组织ＶＥＧＦ蛋白表达和微血管密度（ＭＶＤ）及部分胃癌ＶＥＧＦｍＲＮＡ表达,分析ＶＥＧＦ和ＭＶＤ、及其与胃癌组织学分型、浸润深度、生长方式、淋巴结转移、远处转移和预后的关系。结果ＶＥＧＦ阳性者ＭＶＤ值显著高于阴性者（Ｐ＜００１）,ＶＥＧＦ表达和ＭＶＤ与胃癌浸润深度（Ｐ＜００１）、淋巴结转移（Ｐ＜００５）和远处转移（Ｐ＜０．０５）密切相关,而与组织学分型和生长方式无关（Ｐ＞００５）;ＶＥＧＦ表达阳性或ＭＶＤ≥４３的胃癌患者５年生存率较低;ＶＥＧＦｍＲＮＡ表达与ＶＥＧＦ蛋白表达具有一致性,但其分布不同。结论ＶＥＧＦ与胃癌的血管生成密切相关,对胃癌的生长和浸润转移有促进作用,ＶＥＧＦ和ＭＶＤ可作为反映胃癌生物学行为的指标之一     

Increased angiogenesis in chronic idiopathic myelofibrosis: vascular endothelial growth factor as a prominent angiogenic factor

Increased angiogenesis has been suggested to be implicated in the pathogenesis of chronic idiopathic myelofibrosis (CIMF). We hypothesized that vascular endothelial growth factor (VEGF) drives CIMF-associated angiogenesis, and thus, we aimed to determine its expression and biologic impact in newly diagnosed patients. All patients with CIMF diagnosed between 1990 and 2001, for whom adequate bone marrow specimens and clinical data were available, were deemed eligible. Each case was reclassified according to World Health Organization criteria. Microvessel density (MVD), as assessed by CD34 staining, and VEGF expression were examined by standard immunohistochemistry on paraffin-embedded trephine bone marrow biopsy specimens. The cytogenetic phenotype was determined by fluorescence in situ hybridization. Appropriate summary statistics were used for comparisons between groups; survival was calculated using Kaplan-Meier estimates. Parameters found to be of prognostic significance in univariate analysis were verified in a multivariate Cox regression model. Fifty-five patients with CIMF were investigated. With a median of 43 vascular lumina per 0.747 mm(2), patients with CIMF displayed significantly greater MVD than did age-matched controls (n = 10; median MVD, 19; P < .001) with equal distribution between the various fibrosis stages. Moreover, VEGF expression was significantly increased in CIMF (median, 12 cells/0.747 mm(2) versus 1.4 cells/0.747 mm(2); P = .01) and correlated with MVD (P = .001). However, neither MVD nor VEGF expression correlated with cytogenetics or clinical outcome. We conclude that in CIMF, increased MVD is detectable even in early (pre-)fibrotic stages. Moreover, we found significantly elevated VEGF expression correlating with MVD, thus suggesting VEGF to play a prominent angiogenic role and representing a novel potential therapeutic target in CIMF.     

血管内皮生长因子,微血管密度与乳腺癌淋巴结转移及预后？…

目的　探讨血管内皮生长因子 (VEGF)、微血管密度 (MVD)与乳腺癌淋巴结转移和预后的关系。方法　应用逆转录 聚合酶链反应 (RT PCR)与免疫组织化学SP法 ,检测 92例乳腺癌、12例癌旁组织V组织VEGF表达、MVD以及 2 1例乳腺癌、12例癌旁组织VEGFmRNA的表达。结果　乳腺癌组织 ,VEGF12 1(1.16 %± 0 1% )和VEGF165(1.0 1%± 0 .1% )表达高于癌旁组织 (0 .96 %± 0 .14% )、(0 .88%± 0 .1% ) ,P <0 .0 5～ 0 .0 1。此外 ,MVD与VEGF表达具有显著的正相关关系 (r =0 .70 2 ,P <0 .0 1)。VEGF表达和MVD与乳腺癌淋巴结转移、肿瘤复发关系密切 (P <0 .0 5～ 0 .0 1)。VEGF高表达组和高MVD组的无复发存活时间低于VEGF低表达组和低MVD组 ,差异具有非常显著性 (P <0 0 1)。结论　VEGF与乳腺癌血管生成密切相关 ;VEGF和MVD表达的增高对乳腺癌淋巴结转移、肿瘤复发有促进作用 ;VEGF和MVD对乳腺癌患者的无复发存活时间能起到预测作用     

Correlation between interleukin 10 and vascular endothelial growth factor expression in human esophageal cancer

Interleukin 10 (IL-10) is an immunosuppressive cytokine produced by T-lymphocytes, and is a regulatory molecule for angiogenesis in various cancers. We examined IL-10 and vascular endothelial growth factor (VEGF) gene expression in 45 esophageal cancer patients who underwent surgical resection. Thirty-seven (82.2%) of the 45 esophageal cancers revealed IL-10 gene expression. VEGF121, VEGF165 and VEGF189 isoforms were detected in 93.3% (42/45), 55.6% (25/45) and 26.7% (12/45) of cases, respectively. IL-10 gene expression was significantly correlated with VEGF121 gene expression (P=0.0039, Fisher's test). The results suggested that IL-10 stimulates angiogenic factor gene expression.     

HIF-2α、VEGF、COX-2、MMP-9表达及其与肾细胞癌血管生成的关系分析

目的 探讨HIF-2α(缺氧诱导因子-20α)、VEGF(血管内皮生长因子)、COX-2(环氧化酶-2)、MMP-9(金属基质酶-9)表达及其与肾细胞癌血管生成的关系.方法 应用免疫组化方法,检测79例肾细胞癌手术切除标本的HIF-2α、VEGF、COX-2、MMP-9表达情况,并与MVD(微血管密度)表达进行关联性分析.结果 肾癌组织MMP-9、VEGF的表达均显著高于正常肾组织(P＜0.05);不同临床分期肾癌组织中的MMP-9、VEGF表达有明显差异(P＜0.05).MVD与VEGF、MMP-9蛋白表达呈显著正相关(r=0.381、0.375,P＜0.05);MVD与COX-2表达有关,COX-Z表达0级和4级MVD值最低,与1、2、3级之间比较差异有统计学意义(P＜0.05),0级与4级之间比较差异无统计学意义(P＞0.05),1、2、3级之间差别无统计学意义(P＞0.05).肾细胞癌中HIF-2α阳性组的MVD值高于HIF-2α阴性组中MVD值,差异有统计学意义(t=4.374,P＜0.05);Spearman等级相关分析发现,HIF-2α的表达与MVD间存在正相关关系(r=0.545,P＜0.01).结论 HIF-2α、VEGF、COX-2、MMP-9表达及其与肾细胞癌血管生成之间有明显相关性,在临床上可以根据相关基因表达情况而采取相应的干预措施.     

Angiopoietin-1 and vascular endothelial growth factor expression in human esophageal cancer

Angiopoietin-1 (Ang-1) has been shown to act as an angiogenic promoter in embryonic angiogenesis by promoting vascular branching, pericyte recruitment and endothelial survival. Ang-1 expression has not been examined in human esophageal cancer. We examined Ang-1 and vascular endothelial growth factor (VEGF) gene expression in tumors from 45 esophageal cancer patients who underwent surgical resection. Forty (88.9%) of the 45 esophageal cancers revealed Ang-1 gene expression. VEGF121, VEGF165 and VEGF189 isoforms were detected in 93.3 (42/45), 55.6 (25/45) and 26.7% (12/45) of the cases, respectively. Ang-1 gene expression was significantly correlated with VEGF121 and VEGF165 gene expression (P=0.0289 and P=0.0127, respectively, Fisher's test). The results suggest that Ang-1 is associated with neovascularization in the cancer stroma through VEGF net-works in esophageal cancer.     

Vascular endothelial growth factor expression and neovascularization in non--small cell lung carcinoma

The prognostic significance of microvascular density (MVD) and vascular endothelial growth factor (VEGF) expression were investigated in 15 patients with adenocarcinoma (AC) and 15 patients with squamous cell carcinoma (SCC). Immunohistochemically, VEGF and factor VIII were applied. The average microvessel counts were given as MVD, and VEGF expression was given as VEGF percentage area and VEGF staining degree. Higher values of MVD were obtained in patients with AC (11.47 +/- 3.48) when compared with patients with SCC (7.47 +/- 2.50; P = .001) and also in patients at early stages of disease (10.77 +/- 3.24) when compared with patients at advanced stages (8.47 +/- 3.64; P = .050). A significant correlation was shown between MVD and VEGF percentage area (P = .006) and between VEGF percentage area and VEGF staining degree (P = .000). No significant difference was found in VEGF percentage area between patients with SCC and AC and between patients at early and advanced stages. In conclusion, VEGF or MVD should not be regarded as a solitary prognostic factor but should be supported by other prognostic factors.     

Tissue factor expression and angiogenesis in human prostate carcinoma

In tumors, the switch to the angiogenic phenotype is thought to be controlled by a balance of positive and negative angiogenic factors. Tissue factor (TF) produced by tumor cells has been implicated in the regulation of this "angiogenic switch" through its ability to concurrently induce the expression of angiogenic molecules such as vascular endothelial cell growth factor (VEGF), while inhibiting the expression of anti-angiogenic molecules such as thrombospondin 2. We have examined TF expression and its relationship to angiogenesis and tumor progression in human prostate carcinomas. Most of the prostate carcinoma specimens examined (73%; n = 67) express high levels of TF. Immunohistochemical analysis localized TF expression to the epithelial cells of malignant glands. TF expression was significantly correlated with tumor angiogenesis as measured by the microvessel density (MVD). In addition, TF expression was correlated with the preoperative PSA level, a strong predictor of recurrence in prostate carcinomas. Our findings show that TF expression by the malignant glands in prostate cancer is common and suggest a role for this molecule in regulating prostate cancer progression and angiogenesis.     

Correlation between vascular endothelial growth factor,angiogenesis, and tumor-associated macrophages in invasive ductal breast carcinoma

Angiogenic and anti-angiogenic factors, secreted by tumor, inflammatory, and stromal cells play an important role in regulation of neovascularization. Among the most important of these is vascular endothelial growth factor (VEGF), a specific mitogen for endothelium, which increases vascular permeability and induces proteolytic enzymes necessary for vascular remodeling. Tumor-associated macrophages (TAMs) can express complex functions related to tumor biology, including growth, proliferative rate, stroma formation and dissolution, and neovascularization. The aim of this study was to define, using immunohistochemical analysis, the microvessel density (MVD), VEGF expression, and TAMs level in 97 human invasive ductal breast carcinomas not otherwise specified (NOS), investigate a possible relationship between them and then correlate their values with tumor grade, mitotic activity index (MAI), tumor size and lymph-node status. Statistical analysis showed a strong positive relationship between MVD and VEGF expression ( P<0.001). Furthermore, both MVD and VEGF expression were significantly correlated with tumor grade and lymph-node status, and TAMs infiltration with MAI. TAM level showed a significant positive connection with VEGF expression and MVD. These in situ observations suggest that VEGF stimulates angiogenesis in human invasive ductal breast carcinoma NOS and attracts macrophages to the tumor locus, which then may be involved in angiogenesis promotion. The expression of this angiogenic molecule, and MVD and TAM level, can provide additional prognostic significance and help in the identification of patients who need postoperative adjuvant therapy.     

Mucinous colon carcinomas with microsatellite instability have a lower microvessel density and lower vascular endothelial growth factor expression

We determined the association between cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF) expression, microvessel density (MVD) and microsatellite instability (MSI) or the histological type in colon adenocarcinomas. Sixty-six cases were studied, 28 MSI+ and 38 MSI-. MSI phenotype was determined using polymerase chain reaction. MVD was assessed after CD31 staining in ten x400 fields (0.96 mm(2)) in the most vascularized areas. VEGF and COX-2 expression were studied by means of immunohistochemistry. MVD positively correlated with the levels of VEGF expression (P=10(-4)) and also with the levels of COX-2 expression (P=0.007). MVD and VEGF expression were lower in MSI+ carcinomas (P=0.002 and P=0.03 respectively). When mucinous tumors were excluded from the statistical analysis, the association between low MVD, low VEGF and MSI status disappeared (P=0.5, P=1, respectively). MSI+ mucinous carcinomas had a lower MVD and VEGF expression than other MSI+ carcinomas (P=0.008 and P=0.004, respectively) and MSI- mucinous carcinomas (P=0.01 and P=0.001, respectively). COX-2 expression was lower in medullary carcinomas (P=0.001). In conclusion, mucinous MSI+ colon carcinomas represent a special group of colon adenocarcinomas relating to angiogenesis, with a lower MVD and VEGF expression than both MSI- mucinous carcinomas and MSI+ non-mucinous carcinomas. A low COX-2 expression could be related to the medullary phenotype. However, this has to be confirmed in a larger series. Finally, the low MVD of MSI+ mucinous colon adenocarcinomas could participate in their overall better prognosis.     

人脑星形细胞肿瘤IL-8的表达及其与血管生成的关系

目的：探讨IL-8,VEGF在脑胶质瘤中的表达及与血管生成的关系。方法：应用由45例人脑星形细胞肿瘤和6例正常脑组织组成的组织芯片，采用免疫组织化学技术分别进行IL-8，VEGF，CD34标记并进行半定量，观测在不同病理分级胶质瘤中的表达及与微血管密度（MVD）之间的关系。结果：6例正常脑组织中不表达IL-8，VEGF。45例脑胶质瘤中，27例IL-8呈阳性表达，32例VEGF呈阳性表达，Ⅲ，Ⅳ级脑胶质瘤中IL-8，VEGF的表达比Ⅰ级、Ⅱ级明显增强，IL-8，VEGF评分为强阳性的胶质瘤内MVD明显高于评分为阴性和阳性的MVD（P<0.01）。IL-8表达与MVD呈正相关（rs=0.64，P<0.01）。VEGF表达与MVD之间呈正相关（rs=0.44，P<0.01）。IL-8表达与VEGF表达之间亦呈正相关（rs=0.56，P<0.01）。结论：IL-8，VEGF的表达与胶质瘤病理分级、MVD密切相关，二者在胶质瘤的血管生成中可能相互关联、共同调节肿瘤血管生成。     

Angiogenesis in craniopharyngiomas: Microvascular density and tissue expression of the vascular endothelial growth factor (VEGF) and endostatin

Craniopharyngiomas are benign tumors of the sellar region generally associated with endocrine abnormality and often locally aggressive. Several studies have demonstrated that angiogenesis or neovascularization plays an important role in tumoral growth. The microvascular density (MVD) of craniopharyngiomas was determined in tumor tissue samples from a reference neurosurgery center located in southern Brazil using immunohistochemical methods for two endothelial markers, CD34 and CD105 (endoglin). In addition, tissue expression was determined for an angiogenesis stimulatory factor and for one of its inhibitors, the vascular endothelial growth factor (VEGF) and endostatin, respectively. Endothelial cell immunoreactivity for CD34 and CD105 was observed scattered within the stroma. MVD determined using CD105 antigen was significantly lower than the results obtained by using CD34 antigen. There was no association between the two endothelial markers and tumor extension. The epithelial component showed different degrees of immunoreactivity for VEGF and endostatin in all samples analyzed. We were not able to establish a relationship between angiogenesis in craniopharyngiomas and tumor extension with the endothelial markers used in this study. The investigated vascularization stimulatory and inhibitory factors showed no relation with MVD. We believe that CD105 antigen can be a more specific endothelial marker for tumor angiogenesis than CD34 antigen.     

Prognostic significance of vascular endothelial growth factor expression in clear cell renal cell carcinoma

The purpose of this investigation was to analyze and correlate the immunohistochemical pattern of vascular endothelial growth factor (VEGF) expression with the average of microvessel density (MVD) and other clinicopathologic parameters in clear cell renal cell carcinoma (CCRCC) in order to determine its prognostic significance. Surgical specimens of 93 CCRCC were immunohistochemically analyzed for VEGF expression, MVD with anti-CD31, and Ki 67 proliferative index. VEGF expression was recorded as the percentage of positive tumor cells (<75% and >75%) and as diffuse or perimembranous VEGF expression according to cytoplasmic distribution. Sixty-three (68%) RCC had <75% and 30 had (32%) >75% of VEGF expression. A diffuse cytoplasmic pattern of VEGF expression was found in 61(66%) RCC and a perimembranous one in 32 (34%) RCC. Statistical analysis showed that tumors with >75% of VEGF expression were characterized by lower MVD value (p=0.034), higher nuclear grade (p=0.018), and higher Ki 67 proliferation index (p=0.023). Moreover, a higher nuclear grade of tumor cells was characterized by diffuse cytoplasmic VEGF distribution (p=0.005). This tumor model did not confirm the postulated simple relationship between VEGF overexpression and angiogenesis through high microvessel count. However, the study results indicated that overexpression of VEGF was a worse histologic prognostic parameter in CCRCC.     

Microvessel density, vascular endothelial growth factor and its receptors Flt-1 and Flk-1/KDR in hepatocellular carcinoma.

Assessment of angiogenesis may yield important information for an effective antiangiogenic treatment for hepatocellular carcinoma (HCC) because HCC is characteristically hypervascular We examined the relationship of microvessel density (MVD), vascular endothelial growth factor (VEGF), and VEGF receptors Flt-1 and Flk-1/KDR in 50 patients with HCC and in 3 hepatoma cell lines. VEGF messenger RNA (mRNA) was overexpressed in 26 tumors (52%), and the 3 VEGF isoforms (121, 165, and 189) were present in high frequencies. Flt-1 mRNA was overexpressed in 34 tumors (68%), with levels significantly increased in HCCs compared with the nontumorous livers. Tumor Flt-1 mRNA significantly correlated with tumor VEGF mRNA levels. Within the group of tumors 8.5 cm or less in diameter, tumors with intrahepatic metastasis in the form of tumor microsatellite formation had significantly higher VEGF mRNA levels. MVD assessed by immunohistochemical analysis with CD34 antibody was inversely related to tumor size. Angiogenesis as assessed by MVD and tumor VEGF expression seems to have a more important role in tumor growth and intrahepatic metastasis in smaller HCCs. The differential up-regulation of Flt-1 suggests that it may have an important role in angiogenesis in HCC.     

表皮生长因子受体和P53与食管鳞状细胞癌放疗敏感性的关系

目的 分析食管鳞状细胞癌患者标本中表皮生长因子受体(EGFR)和P53表达水平与其临床病理特征的相关性,探讨术前放疗对EGFR和P53表达的影响,为临床食管鳞状细胞癌手术联合放疗的治疗策略提供理论依据.方法 采用免疫组织化学方法检测食管鳞状细胞癌患者标本中EGFR、P53蛋白的表达水平,分析其表达与食管鳞状细胞癌临床病理参数的关系,对比术前放疗对患者癌组织中EGFR和P53表达水平的影响.结果 与正常食管黏膜上皮组织相比,食管鳞状细胞癌组织中EGFR和P53的表达水平均显著升高;食管鳞状细胞癌组织中EGFR和P53的表达均与其组织学分级、浸润程度、有无区域淋巴结转移呈正相关;术前放射治疗可显著降低食管鳞状细胞癌组织中EGFR和P53的表达水平.结论 在食管鳞状细胞癌中,EGFR和P53的表达水平与其临床病理特征有密切关系,且呈正相关,检测两种蛋白的表达水平对食管鳞状细胞癌的恶性程度及预后判断具有重要的临床意义.     

Vascular endothelial growth factor (VEGF), VEGF receptors expression and microvascular density in benign and malignant thyroid diseases

Angiogenesis is critical for the growth and metastatic spread of tumours. Vascular endothelial growth factor (VEGF) is the most potent inducer of neovasculature, and its increased expression has been related to a worse clinical outcome in many diseases. The purpose of this study was to evaluate the relation between VEGF, its receptors (VEGFR-1 and VEGFR-2) and microvessel density (MVD) in thyroid diseases. Immunostaining for VEGF and VEGF receptors was performed in 66 specimens of thyroid tissue, comprising 17 multinodular goitre (MNG), 14 Graves' disease, 10 follicular adenoma, 8 Hashimoto's thyroiditis, 7 papillary carcinoma and 10 normal thyroid specimens. Thyrocyte positivity for VEGF and VEGF receptors was scored 0-3. Immunohistochemistry for CD31, and CD34 on the same sections was performed to evaluate MVD. Immunohistochemical staining of VEGF in thyrocytes was positive in 92% of all the thyroid tissues studied. Using an immunostaining intensity cut off of 2, increased thyrocyte staining was seen in follicular adenoma specimens, MNG and normal thyroids compared with Hashimoto's thyroiditis and Graves' disease (P < 0.05). Similarly, VEGF thyrocyte expression in Graves' disease was less than other pathologies (P < 0.05). VEGFR-1 expression and the average MVD score did not differ between the different thyroid pathologies. VEGF expression was lower in autoimmune pathologies compared to autonomous growth processes. Conversely, both VEGFR-1 and VEGFR-2 were widely expressed in benign and neoplastic thyroid disease, suggesting that the up-regulation of VEGF and not its receptors occurs as tissue becomes autonomous. There was no clear relationship between MVD measurement and thyroid pathology.