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Korean Journal of Obstetrics & Gynecology 2003;46(3):559-567.
Published online March 1, 2003.
Expression of Vascular Endothelial Growth Factor, Microvessel Density and Prognosis in Epithelial Ovarian Tumors.
Seong Lan Choi, Ji Young Kim, Il Woong Park, Hyun Chul Jun, Du Suck Jung, Joong Dong Cho, Hyung Seok Kim, Ji Shin Lee, Jong Jae Jung, Ho Sun Choi
1Department of Obstetrics and Gynecology, Seonam University, College of Medicine, Namwon, Korea.
2Department of Pathology, Seonam University, College of Medicine, Namwon, Korea.
3Department od Obstetrics and Gynecology, Chonnam University Medical School, Gwangju, Korea.
Abstract
OBJECTIVE
It is still unclear whether angiogenic potential, which is believed to be a prerequisite for tumor development, is an important prognostic factor in ovarian carcinoma. The current study was designed to examine the relationship among Vascular endothelial growth factor (VEGF) expression, angiogenesis in ovarian neoplasms and clinicopathological prognostic variables. METHODS: A according to the WHO classification and FIGO staging epithelial ovarian carcinoma was classified. Microvessel density and VEGF status were evaluated by immunohistochemistry in 77 epithelial ovarian carcinomas. RESULTS: Positive immunostaining for VEGF was observed in 92.6% (50 out of 54) of ovarian carcinomas, which was significantly higher than that of low malignant potential (LMP) tumors (12 out of 23; 52.2%) (p<0.001). In ovarian carcinomas, positive VEGF immunostaining was also observed more frequently, even though not significantly, in tumor of elder age group (more than 60 years) (p=0.05) and less differentiated (p=0.05). CD34 immunostaining revealed increased microvessel density in ovarian carcinomas larger than 10 cm in size (p=0.029) and in mucinous type tumors (p=0.025). Microvessel counts of epithelial ovarian carcinomas examined were not correlated with VEGF expression. Histologic type (p=0.0428), differentiation (p=0.0083) and FIGO stage (p=0.0004) also influenced overall survival of ovarian carcinomas in univariate analysis. But multivariate analysis revealed that disease stage was the only significant and independent prognostic factor of ovarian carcinomas (p=0.001). In advanced ovarian tumors (stage III/IV), microvessel density was the only significant prognostic factor (p=0.002). CONCLUSION: Therefore, the expression of VEGF could be used as an adjuvant indicator of differing borderline tumor from ovarian carcinoma. And microvessel density of advanced ovarian carcinoma may enhance the predictability of patient at high risk for tumor progression who are potential candidate for further aggressive therapy.
Key Words: Epithelial ovarian tumors, Vascular endothelial growth factor (VEGF), Microvessel density, Prognostic factor


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