Janusz Dembowski, Paweł Kowal, Michał Wróbel, Anna Kołodziej, Romuald Zdrojowy, Tomasz Szydełko, Tadeusz Niezgoda
- Katedra i Klinika Urologii Akademii Medycznej we Wrocławiu
Kierownik kliniki: prof. dr hab. Jerzy Lorenz
kidney, renal cancer, Vascular Endothelial Growth Factor (VEGF), angiogenesis
- Angiogenesis is involved either: in physiologic (organogenesis, growth) and in pathologic states (inflammation, wound healing, tumour's growth). A lot of experimental works confirm the role of angiogenesis in the neoplasm's growth and metastases formation. One of the main angiogenesis activators is Vascular Endothelial Growth Factor (VEGF). Because one third among renal cancer patients presents metastatic disease in the moment of diagnosis or during observation the impact of VEGF on prognosis and it's correlation with staging and grading is supposed
- material and methods
- 32 patients who underwent radical nephrectomy or nephron sparing surgery from December 1999 to August 2001. From every surgical paraffin embedded specimen, three samples were taken (edge, central part of the tumour and adjacent renal parenchyma), and stained immunohistochemicaly for visualization of VEGF expression with commercial kit AF-293-NA (R&D Systems®). VEGF expression was then estimated semi quantitatively (0, 1, 2, 3, 4). Expression of VEGF was correlated with staging, grading and as a predictor of advanced disease and cancer related death.
- VEGF expression in the renal cancer specimens was higher in samples from the edge of the tumour then in samples from the tumour center and adjacent renal parenchyma. Average VEGF expression was 2,37; 1,73; 0,77, and modality 3; 2; 1 respectively.
- Expression of VEGF in samples from the edge of the tumour can predict risk of the cancer death – it is higher in this group of patients (n=10) in comparison to another patients (n=20) (average VEGF expression 3,1 vs. 2,0)
- VEGF is correlated positively with „T” (R = + 0,4) and with „G” (R = + 0,4)
- VEGF expression is higher on the edge than in central part of the tumor VEGF expression correlated with aggressive disease (high nuclear grade) and risk of cancer death. It may be helpful in qualification to the antiangiogenic therapy, in the case of more advanced renal cancer.