The correlation of angiogenesis with metastasis in primary cutaneous melanoma:: a comparative analysis of microvessel density, expression of vascular endothelial growth factor and basic fibroblastic growth factor

Aim: To establish whether there is a correlation between angiogenesis and metastasis in primary cutaneous melanoma (PCMM). Methods: We studied the microvessel density and the expression of vascular endothelial growth factor ( VEGF) and basic fibroblastic growth factor ( bFGF) in 22 cases of PCMM with metastasis at presentation ( metastatic group) and 28 cases of PCMM without metastasis for 24 months or more (non-metastatic group). Microvessels were stained with CD31/PECAM-1 antibody and counted. We assessed the proportion of VEGF expression in tumour cells, lymphocytes infiltrating the tumour (TIL) and lymphocytes at the periphery of the tumour, as well as the proportion of bFGF expression in tumour cell cytoplasms, nuclei and intra-and peritumoral vessels. Results: An increased microvessel density was detected in the metastatic group ( 15 - 33 [ 24.09 +/- 5.55] versus 2 - 24 [12.96 +/- 6.02]). Moreover, enhanced expression of VEGF in tumour cells and peritumoral lymphocytes (Chi-square p=0.038 and p=0.018) and bFGF in peritumoral vessels (chi(2) p=0.013) correlated with the simultaneous presence of melanoma metastasis in PCMM. Furthermore, microvessel density was correlated with the expression of bFGF in peritumoral vessels (rs=0.53, p=0.049) and VEGF in tumour cells ( rs=0.37, p=0.019). Conclusion: Microvessel density as well as the expression of both VEGF and bFGF might be informative concerning the progression of melanoma.