The Expression Of Vascular Endothelial Growth Factors In Ovarian Carcinoma Ascites And Tissue And Its Meaning

Objective: Ovarian carcinoma has poor 5-year suvial and always with much ascites. Neoplastic angiogenisis and lymphangiogenisis are essential for the growth of solid tumor tissue in both primary and metastatic sites. Vascular endothelial growth factor (VEGF) family is now accepted as a powerful angiogenic agent in neoplastic tissues .To examine the level of ascites VEGF-A, VEGF-C in patients with ovarian epithelial tumor, primary peritoneal papillary serous carcinoma (PPSPC), endometriosis (EDM) and their expression in patients with ovarian epithelial tumor and evaluate the relationship between VEGF-A> VEGF-C and clinicopathological factors.Methods: Ascites levels of VEGF-A , VEGF-C in 60 specimens of ovarian epithelial tumor, 10 specimens of primary peritoneal papillary serous carcinoma and 7 specimens of endometriosis were examined by Enzyme-linked immunosorbent assay (ELISA).The tissue expression levels of VEGF-A , VEGF-C in 44 specimens of ovarian epithelial tumor were examined immunohistochemically.Result: (1) Ascites VEGF-A levels before operation in patients with epithelial ovarian carcinoma (EOC) were significantly higher than those with benign ovarian tumor (BET), borderline ovarian tumor (BOT) and EDM (P<0. 05);ascites VEGF-A levels before operation in patients with PPSPC were significantly higher than those with BET and EDM (P<0. 05) . In malignant ascites VEGF-A levels in patients at advanced stage,low differentiation .positive ascites cytology and big volume of ascites (> 1000ml) were apparently higher than those at early stage ( P<0.05 ) ,high differentiation (P<0. 05) , negtive ascites cytology (P<0. 05) and small volume of ascites (P<0. 05) , there were no significant difference amongpathology types. Ascites VEGF-C levels before operation in patients withEOC were significantly higher than those with BET (P<0. 05) .In malignantascites VEGF-C levels in patients at advanced stage,low differentiation ,lymphnode metastasis, positive ascites cytology and big volume of ascites (> 1000ml)were apparently higher than those at early stage ( P<0.01 ) ,highdifferentiation (P<0. 01), without lymph node metastasis (P<0. 05), negtiveascites cytology ( P<0.05 ) and small volume of ascites (<1000)(P<0. 05) , there were no significant difference among pathology types. (2)Positive immunostaining for VEGF-A was abserved in 82.7% of EOC,whichwas significantly higher than that of BOT 25% (P<0. 05) , BET 27.3%(P<0.05) . The tissue expressions of VEGF-A were correlated significantlywith tumor differentiation (PO.05), there were no significant differencebetween VEGF-A and other clinicpathologic features. Positiveimmunostaining for VEGF-C was abserved in 51.7% of EOC,which wassignificantly higher than that of BOT 25% (P<0. 05) , BET 0 (P<0.05) . Thetissue expressions of VEGF-C were correlated significantly with tumordifferentiation (P<0.05) and lymph node metastasis (P<0. 05) , there were nosignificant difference between VEGF-C and other clinicpathologic features.Conclusion: (1) Ascites VEGF-A levels before operation in patients withEOC and PPSPC were significantly higher than those with BET and EDM.(2)The tissue expressions of VEGF-A in patients with EOC were significantlyhigher than those with BET and BOT.(3) The high ascites VEGF-A levels inpatients with EOC and PPSPC and the high tissue expressions of VEGF-Awere correlated significantly with tumor malignant biology behavior .includingclinical stage, differentiation, volume of ascites and ascites cytology.(4) AscitesVEGF-C levels before operation were significantly higher than those withBET .(5) The tissue expressions of VEGF-C in patients with EOC were significantly higher than those with BET and BOT.(6) he high ascites VEGF-C levels in patients with EOC and the high tissue expressions of VEGF-C were correlated significantly with tumor malignant biology behavior including lymph node metastasis, clinical stage, differentiation, volume of ascites and ascites cytology.(7) Ascites VEGF-A levels may be used as a marker for the diagnosis and prognosis of ovarian carcinoma;tissue expression of VEGF-C reflects the aggressiveness of the spread of tumor in ovarian cacinoma,it has predictive value for identitying high-risk patients who have a poor prognosis.