Journal
CLINICAL & TRANSLATIONAL ONCOLOGY
Volume 21, Issue 9, Pages 1250-1259Publisher
SPRINGER INTERNATIONAL PUBLISHING AG
DOI: 10.1007/s12094-019-02051-9
Keywords
VEGF-C; Twist; Breast cancer; Prognosis; Lymphatic vessel invasion
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Funding
- Natural Science Foundation Committee [81602345]
- Shantou science and technology program, China [123,2015]
- Science and Technology Planning Project of Guangdong Province, China [2016A020215145]
- Medical Scientific Research Foundation of Guangdong Province, China [A2016589]
- Xiamen University
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BackgroundAngiogenesis is an indispensable step in the growth and invasiveness of breast cancers involving a series of exquisite molecular steps. Pro-angiogenic factors, including vascular endothelial growth factor (VEGF), have been recognized as pivotal therapeutic targets in the treatment of breast cancer. More recently, a highly conserved transcription factor Twist has been reported to be involved in tumor angiogenesis and metastasis.MethodsThe expression of VEGF-C and Twist was immunohistochemically determined in tissue samples of primary tumors from 408 patients undergoing curative surgical resection for breast cancer. The correlations of VEGF-C and Twist expressions with clinicopathologic parameters as well as survival outcomes were evaluated.ResultsOf the 408 patients evaluated, approximately 70% had high expression of VEGF-C which was significantly associated with advanced tumor stages (P=0.019). Similarly, VEGF-C expression was associated with the proliferation index Ki67, N3 lymph node metastasis, and D2-40-positive lymphatic vessel invasion (LVI) in a univariate analysis. Furthermore, patients with high expressions of VEGF-C and Twist (V+T+) had significantly increased lymph node metastasis, higher clinical stage, and worse disease-free survival, DFS (P=0.001) and overall survival, OS (P=0.011).ConclusionsOur results suggested that co-expression of VEGF-C and Twist was associated with larger tumor size, higher numbers of lymph node involvement, D2-40-positive LVI, higher risk of distant metastasis, and worse DFS or OS in breast cancer patients.
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