The Clinical Significance Of ESM-1,VEGF,FLK-1 In Non Small Cell Lung Cancer

Objective :To investigate the expression of ESM-1,VEGF and FLK-1 in NSCLC and paratumor tissues, and to explore their correlations with angiogenisis and other clinical pathophysiological characteristics of NSCLC.Methods: The expression of ESM-1 was detected using immunofluorescence technique in 60 specimens of NSCLC and 21 specimens of adjacent non-cancerous tissues. Immunohistochemical S-P method was performed to estimate the expression of VEGF, FLK-1 and MVD. Statistcal analysis was performed to analyze the expression difference between tumor tissues and adjacent non-cancerous tissues. Furthermore, the correlations among ESM-1, VEGF, FLK-1, MVD and other clinical pathophysiological characteristics were also analyzed.Results: l. The ESM-1-positive rates were 78.33%(47/60) in NSCLC group and 14.29%(3/21) in the control group. The positive rates of VEGF were 73.33%(44/60)in NSCLC group and 19.05%(4/21)in the control group. The FLK-1-positive rates were 71.67%(43/60) in NSCLC group and 19.05%(4/21) in the control group. There was significant difference between them(P<0.05).2. The MVDs was 23.58±5.25 in NSCLC group and 10.36±3.65 in normal lung tissues. The difference between them was also significant (P<0.05 ). 3. The positive rates of ESM-1 were 77.42%(24/31)in adenocarcinoma, 80.00%(20/25) in squamous cell carcinoma and 75.00%(3/4) in big cell lung cancer. The VEGF-positive rates were 74.19%(23/31) in adenocarcinoma, 72.00%(18/25) in squamous cell carcinoma and 75.00%(3/4) in big cell lung cancer. The positive rates of FLK-1 were 70.96%(22/31)in adenocarcinoma, 72.00%(18/25)in squamous cell carcinoma and 75.00%(3/4) in big cell lung cancer. There was no significant difference among them.4.. In stageⅠ+ⅡandⅢ+Ⅳof NSCLC, the positive rates of ESM-1 were 70.59%(24/34) and 88.46%(23/26), In stageⅠ+ⅡandⅢ+Ⅳof NSCLC, the positive rates of VEGF were 61.76%(21/34) and 88.46%(23/26), the positive rates of FLK-1 were 58.82%(20/34) and 88.46%(23/26).The diferences of ESM-1,VEGF and FLK-1 expression between stageⅠ+ⅡandⅢ+Ⅳwere significant respectively (P<0.05).5.In the group with lymph node metastasis and the group without lymph node metastasis, the positive rates of ESM-1 were 84.78%(39/46) and 57.14%(8/14),the positive rates of VEGF were 89.13%(41/46) and 64.29%(9/14), the positive rates of FLK-1 were 86.96%(40/46) and 64.29%(9/14). The differences of ESM-1, VEGF and FLK-1 expression between the two groups were significant respectively (P< 0.05 ).6.The MVDs in the ESM-1-positive group and the ESM-1-negative group were 25.16±5.12 and 18.97±3.28 respectively, the difference was significant (P<0.05). The MVDs in the VEGF-positive group and the VEGF-negative group were 24.68±4.65 and 19.05±3.23 respectively, the difference was significant (P<0.05). The MVDs in the FLK-1-positive group and the FLK-1-negative group were 24.65±4.34 and 18.92±3.35 respectively, the difference was also significant (P<0.05).7.There was positive correlation among the expressions of ESM-1, VEGF and FLK-1 in NSCLC (P<0.05).Conclusions:l. The expressions of ESM-1, VEGF and FLK-1 in NSCLC tissues are higher than that in adjacent non-cancerous tissues. The expressions of ESM-1, VEGF and FLK-1 are associated with lymph node metastasis and TNM stage, not associated with the histological type of NSCLC. There was positive correlation among the expressions of ESM-1, VEGF and FLK-1 in NSCLC.2. The microvessel density of tumor tissues in NSCLC was higher than that of the control group. The expressions of ESM-1, VEGF and FLK-1 in NSCLC tissues also had a correlate with MVD, which indicated that ESM-1, VEGF and FLK-1 might play very important roles in tumor angiogenesis in NSCLC.3. ESM-1,VEGF,FLK-1 might be the biological markers for advanced stage of lung cancer and poor prognosis.