THE IMPORTANCE OF SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR -C,-D AND -C/D RATIO TO DETERMINE LYMPH NODE METASTASIS IN BREAST CANCER; PROSPECTIVE CLINICAL STUDY

Abstract

OBJECTIVE: Nodal metastasis is recognized as a powerful prognostic marker in breast carcinoma, however confl icting reports exist for the precise involvement of VEGF-C and VEGF-D in lymph node metastasis. The aim of this prospective study was to determine serum VEGF-C, VEGF-D levels and correlation of VEGF-C/D ratio with lymph node metastasis in breast carcinoma.MATERIAL and METHOD:In this study, serum levels of VEGF-C, VEGF-D were determined by ELISA in patients with pretreated breast carcinoma (n=80) and healthy women (n=20). Mann-Whitney U and Kruskal-Wallis tests were used as statistical methods for comparisons of the variables, and the discrimination of VEGF-C, VEGF-D and VEGF-C/D ratio was assessed by calculating the area under the receiver operating characteristic curve.RESULTS: The mean age of the patients was 50.9 (22-81) years. The mean level of VEGF-C was signifi cantly higher in patients than control (p=0.033); however, no statistically signifi cant diff erence was observed for serum VEGF-D levels. VEGF-D was decreased in patients having lymph nodes metastases as compared to patients having negative axillary lymph node (p=0.030) metastases. The VEGF-C/D ratio was signifi cantly higher in patients with lymph node metastasis than in patients having negative axillary lymph node (p=0.040). CONCLUSION: Our study shows that VEGF-C and VEGF-D are regulators in the lymph node metastases in breast cancer. It may be advocated that the reduced level of VEGF-D may allow more lymphangiogenic VEGF-C to bind the receptors.

Keywords

• breast cancer
• vascular endothelial growth factors
• lymph node
• metastases