Vascular Endothelial Growth Factor-C,D And Their Specific Recepter: Flt-4 Expression In Cerebral Arteriovenous Malformations

Objectives: In this report, we used immunohistochemical techniques to examine the expression of VEGF-C,VEGF-D and their specific receptor: Flt-4 in cAVM. Normal brain vasculars were used as control. And then we investigated the relationship between VEGF-C,VEGF-D and their specific receptors: Flt-4 expression and the development of cAVM. This study will provide useful information for better understanding the pathomechanism of cAVM.Methods: The specimens consisted of 42 cAVM tissues obtained from patients who underwent surgery in the department of neurosurgery in Huaxi Hospital during June 2005 to August 2006. 33 of them were confirmed by DSA before operations and 9 by pathology post operations. 16 normal brain vasculars were used as control ,which obtained from cranial brian trauma patients who underwent lobectomy during the same period .We observed the construction features of the vascular wall involved in the cAVM nidus and examined the expression of VEGF-C,VEGF-D and their specific receptor : Flt-4 in cAVM specimens via immunohistochemical techniques. Results: Positive staining of VEGF-C,VEGF-D and their specific receptor: Flt-4 was observed chiefly in the endothelial cells and smooth muscle cells of the vascular wall involved in the cAVM nidus. And there were also a little positive staining of them in normal brain vascular wall, and there was statistically significant difference between the two groups. Compare the positive rate of them for the patients with different nidus sizes, there was. statistically significant difference between them. And also, compare the positive rate of them for the patients with different ages, there was statistically significant difference between them. The positive rate of VEGF-C is higher in ruptured cAVM , but without significantly differences for the positive rate of VEGF-D and Flt-4.Conclusions: The expression of VEGF-C,VEGF-D and their specific receptor: Flt-4 in cAVM nidus is significantly higher than that of normal brain vasculars . The positive rate of VEGF-C,VEGF-D and Flt-4 are direct correlation the nidus' sizes of the patients , and also the positive rate of them are direct correlation the ages of the patients, which both indicate that VEGF-C,VEGF-D and their receptors: Flt-4 may play an effective role in the development ofcAVM. VEGF-C may play a role in the rupture of cAVM.