Journal
TRANSLATIONAL CANCER RESEARCH
Volume 10, Issue 1, Pages 210-222Publisher
AME PUBL CO
DOI: 10.21037/tcr-20-2498
Keywords
Vascular endothelial growth factor-C (VEGF-C); survivin; esophageal squamous cell carcinoma (ESCC); lymph node metastasis; prognosis
Categories
Funding
- Guangdong Medical Science Research Fund [A2016589]
- Science and Technology Planning Project of Guangdong Province [2016A020215145]
- Medical Science and Technology Research Fund Project of Guangdong Province [[2020]15, B2020210]
- Science and Technology Planning Project of Shantou [[2018]121, 190917085269842, [2019]62, [2019]106]
- Science and Technology Special Fund of Guangdong Province of China [190829105556145]
- Special Fund for Science and Technology Innovation of Guangdong Province of China [180918114960704]
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In patients with ESCC, high levels of the co-expression of VEGF-C and survivin were significantly correlated with tumor staging, lymph node metastasis, differentiation, as well as worse disease-free survival and overall survival. The combined detection of VEGF-C and survivin could serve as a feasible and effective marker to predict the prognosis and survival of ESCC patients.
Background: Lymphatic metastasis is one of the main factors affecting prognosis in esophageal squamous cell carcinoma (ESCC). Vascular endothelial growth factor-C (VEGF-C) is an important factor that promotes lymphangiogenesis. Survivin also plays a significant role in lymphatic invasion. However, the role and mechanism of their co-expression are still unclear in ESCC. The purpose of this study was to investigate whether the co-expression of VEGF-C and survivin could be a potential marker to predict patient prognosis and survival in ESCC. Methods: The levels of VEGF-C, vascular endothelial growth factor receptor 3 (VEGFR-3), survivin, and Ki-67 were determined by immunohistochemistry (IHC) in 97 ESCC patient tumors. The correlations of co-expression of VEGF-C and survivin with pathological features and survival results were also assessed. Results: High VEGF-C expression was observed in 64.9% of the patients and significantly correlated with T stage (P=0.024), node status (P=0.038), and lymph node metastasis (P=0.015). High survivin expression was significantly associated with T stage (P=0.013), N stage (P=0.016), lymph node metastasis (P=0.005), and differentiation (P=0.044) in 67.0% of the patients. Co-expression of VEGF-C and survivin (V+S+) was significantly associated with T stage (P<0.001), N stage (P=0.015), lymph node metastasis (P=0.003), differentiation (P=0.0045), and Ki-67 levels (P=0.024). High expression of VEGF-C or survivin was associated significantly with worse disease-free survival (DFS) and overall survival (OS) (P<0.05). Moreover, the V+S+ group had a worse DFS (P<0.001) and OS (P=0.001) than any other group (i.e., V-S-, V+S-, V-S+) Furthermore, multivariate DFS analyses (95% CI: 1.147-2.220, P=0.006) and multivariate OS analyses (95% CI: 1.080-2.193, P=0.017) revealed that co-expression of VEGF-C and survivin was an independent prognostic factor in ESCC patients. Conclusions: Co-expression of VEGF-C and survivin was predictive of poor prognosis in ESCC. Combined detection of VEGF-C and survivin could represent a feasible and effective marker to predict the prognosis and survival of ESCC patients.
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