Predictive Significance of Preoperative Serum VEGF-C and VEGF-D, Independently and Combined With Ca19-9, for the Presence of Malignancy and Lymph Node Metastasis in Patients With Gastric Cancer

Background: Cumulative evidence demonstrate that lymphangiogenic vascular endothelial growth factors (VEGF)-C and -D are over-expressed and associated to lymph node metastasis (LNM) in gastric cancer. The flint of I 11 S study is to investigate whether preoperative serum levels of VEGF-C and VEGF-D could be useful tumor markers in patients with operable gastric adenocarcinoma Methods: We prospectively examined serum samples from 40 patients and 40 non-cancer controls using enzyme-linked immunosorbent assay (ELISA). Logistic regression analysis was implemented VEGF-C and VEGF-D were studied independently and in combination with Ca 19-9 Results: In gastric cancer patients. preoperative VEGF-C was significantly lower as compared to controls and to postoperative VEGF-C (P < 0.001): preoperative VEGF-D was significantly higher as compared to controls and to postoperative VEGF-D (P < 0 001). ROC curve analysis identified a VEGF-C/VEGF-D cut-off value of < 2.7 for the presence of gastric cancer, with 83% sensitivity and 75% specificity (P < 0 001) Backward stepwise selection modeling including sex. age. VEGF-D and Ca 19-9, predicted the presence of LNM with 86% sensitivity and 82% specificity (P < 0 001) Conclusion: Circulating levels of VEGF-C and VEGF-D could play a role as biomarkers for serological detection and staging in gastric cancer J. Surg. Oncol. 2010;102;699-703 (C) 2010 Wiley-Liss, Inc