Prognostic impact of VEGF, CD31, CD34, and CD105 expression and tumour vessel invasion after radical surgery for IB–IIA non-small cell lung cancer
- 1Department of Thoracic Surgery, Policlinic Tor Vergata University, 00133 Rome, Italy
- 2Department of Biochemistry and Biophysic “F. Cedrangolo”, Section of Anatomic Pathology, Second University, Naples, Italy
- 3Medical Oncology and Pathology, Campus Bio-Medico University, 00155 Rome, Italy
- Correspondence to: Professor T C Mineo Department of Thoracic Surgery, Policlinic Tor Vergata University, 00133 Rome, Italy; and Dr G Tonini Medical Oncology, Campus Bio-Medico University, Rome. Via Emilio Longoni, 69, 00155, Rome, Italy;
- Accepted 7 January 2004
Aims: To evaluate the prognostic impact of tumour angiogenesis assessed by vascular endothelial growth factor (VEGF), microvessel density (MVD), and tumour vessel invasion in patients who had undergone radical resection for stage IB–IIA non-small cell lung cancer (NSCLC).
Methods: Fifty one patients (42 men, nine women; mean age, 62.3 years; SD, 6.9) undergoing complete surgical resection (35 lobectomy, 16 pneumonectomy) of pathological stage IB (n = 43) and IIA (n = 8) NSCLC were evaluated retrospectively. No patient underwent postoperative chemotherapy or neoadjuvant treatment. Tumour specimens were stained for VEGF and specific MVD markers: CD31, CD34, and CD105.
Results: VEGF expression significantly correlated with high CD105 expression (p < 0.0001) and tumour vessel invasion (p = 0.04). Univariate analysis showed that those patients with VEGF overexpression (p = 0.0029), high MVD by CD34 (p = 0.0081), high MVD by CD105 (p = 0.0261), and tumour vessel invasion (p = 0.0245) have a shorter overall survival. Furthermore, multivariate Cox regression analysis showed that MVD by CD34 (p = 0.007), tumour vessel invasion (p = 0.024), and VEGF expression (p = 0.042) were significant predictive factors for overall survival. Finally, the presence of both risk factors, tumour vessel invasion and MVD by CD34, was highly predictive of poor outcome (odds ratio, 3.4; 95% confidence interval, 1.7 to 6.5; p = 0.0002).
Conclusions: High MVD by CD34 and tumour vessel invasion are more closely related to poor survival than the other neoangiogenetic factors in stage IB–IIA NSCLC. This may be because these factors are more closely related to the metastatic process.
- CI, confidence interval
- MVD, microvessel density
- NSCLC, non-small cell lung cancer
- OR, odds ratio
- TBS, trisphosphate buffered saline
- VEGF, vascular endothelial growth factor