Significance of Angiogenesis and bFGF Expression in the Prognosis of Gastric Cancer

Kim, Young Woo; Kim, Jin Pok; Han, Ho Seong; Bae, Jae Moon; Yang, Han Kwang

Abstract

BACKGROUND
: In order to evaluate the clinical relevance of angiogenesis in patients with gastric cancer, the authors investigated the microvessel count in gastric cancer tissues and compared the results with several clinicopathological factors and the prognosis. The production of basic fibroblast growth factor (bFGF) which is known to have strong angiogenic activity in gastric cancer, was also evaluated. In addition the relationship between the expression of bFGF in human gastric carcinoma tissues and tumor angiogenesis, as well as patient outcome, were investigated.
METHODS
: Formalin-fixed paraffin-embedded gastric cancer tissues from 97 randomly selected patients who underwent radical gastric resections in 1990 at Seoul National University Hospital were used and microvessels were stained with factor VIII-related antigen polyclonal antibody, and bFGF immunostaining was performed with polyclonal anti-bFGF antibody. The microvessel count was determined in 200 microscopic field. Conventional H&E stained tissue slides were reviewed again and patient survival were followed up. The relationships among angiogenesis, bFGF expression, and pathological parameters were analyzed with the Student t-test, the ANOVA test, and the chi-square test. The survival rate was calculated with the Kaplan-Meyer method and a Log-rank test was done for analysis of prognostic factors. RESULT : The microvessel count ranged from 22 to 210, and the median count was 61. The microvessel count was significantly lower in patients with early gastric cancer or EGC mimicking advanced gastric cancer. Lymph node metastasis, depth of invasion, and Lauren's and Ming's classification were notsignificantly related with microvessel count, even though there was some tendency. bFGF expression was strong in undifferentiated carcinomas, Borrmann type III & IV, deeper invasion, and higher stage.However, there was no significant difference of survival rate between the higher and the lower vascular groups and between the strong and the weak bFGF expression groups.
CONCLUSIONS
: Microvessel count and bFGF expression are presumed to be related with tumor pro gression. However, their prognostic value was not significant in this study. In view of profuse angiogenic activities and expression of angiogenic growth factor, future therapeutic targeting for angiogenesis could be reasonable in patients with gastric cancer.