Expression of VEGF-A in Epithelial Ovarian Cancer: Correlation with Morphologic Types, Grade and Clinical Stage

AIM

The objective of this study was to evaluate the expression pattern of vascular endothelial growth factor A (VEGF A) in epithelial ovarian cancers (EOC) and to correlate the intensity of expression with morphologic types, histologic grade and clinical stage of the disease.

METHODS

Tissue microarrays were constructed from paraffin blocks of 78 cases of EOC in duplicate. Immunohistochemical staining for VEGF A was carried out with mouse monoclonal antibody and the intensity was scored independently by two pathologists (CSP and MA).

RESULTS

Twenty six of 78 (33.3%) cases of primary malignant epithelial ovarian neoplasm showed high VEGF A expression. Among high expressors, 23 were seen in serous carcinomas, two in undifferentiated carcinomas and one in mixed carcinoma. High expression was not seen in other types like, endometrioid, mucinous and clear cell carcinomas. High VEGF-A expression was also associated high grade and advanced stage of the disease.

CONCLUSION

High VEGF-A expression in epithelial ovarian cancer was found to be associated with serous morphology, high grade and advanced stage of the disease. Though some degree of VEGF A expression was seen in most ovarian carcinomas, high expression was seen in only one third of cases and this may help in selecting the patients for targeted therapy with antiangiogenic agents.

Association of vascular endothelial growth factor single nucleotide polymorphisms on the prognosis of breast cancer patients

BACKGROUND

Vascular endothelial growth factor (VEGF), a major mediator of vascular permeability and angiogenesis, may play a pivotal role in mediating the development and progression of breast cancer. In the present study, we examined the genetic variations of the VEGF gene to assess its possible relation to breast cancer.

MATERIALS AND METHODS

A total of 200 patients with histologically confirmed cases of breast cancer and 200 healthy women were genotyped for VEGF single nucleotide polymorphisms (405G > C and -1154G > A) by polymerase chain reaction-restriction fragment length polymorphism analysis. Pre-operative plasma VEGF levels were determined by enzyme-linked immunosorbent assay in 200 women with breast cancer and in 200 normal female controls.

RESULTS

The genotype frequencies of the +405G > C, -1154G > A polymorphisms did not show a significant deviation from the Hardy-Weinberg expectation. The minor allele frequencies of the +405G > C and -1154G > A polymorphisms among cases and controls were 33.5% (C allele), 31.5% (A allele) and 35% (C allele), 34.5% (A allele) respectively. +405GG and -1154GG genotypes were associated with higher levels of VEGF among breast cancer cases and controls. Increased plasma VEGF levels were significantly associated with, clinical stage of the disease (P = 0.035).

CONCLUSION

Although none of the polymorphisms were significantly associated with breast cancer, some of the VEGF genotypes may influence tumor growth through an altered expression of VEGF and tumor angiogenesis.

Measurement of the skin microcirculation through intact bandages using laser Doppler flowmetry

The microcirculation under compression bandages has been assessed by numerous methods; however, the measurement techniques can disrupt the bandage-skin interface, affecting the measurement. In this study, a non-invasive method for measuring cutaneous blood flow using laser Doppler flowmetry (LDF) is presented. Ten volunteers had their microcirculation assessed by a laser Doppler probe being placed on their upper forearm with and without a light-transmissive gel and with a compression bandage plus light-transmissive gel. A circulatory challenge to the bandaged forearm in two of the volunteers was also undertaken. The median (95% confidence interval) perfusion (p.u.) for the skin surface was 24 (15-33) perfusion units (p.u.), and the skin plus light-transmissive gel demonstrated a higher perfusion: 66 (50-82) p.u., (p < 0.012). The addition of the compression bandage, with additional gel allowed to permeate through to the underlying skin, decreased the perfusion to 27 (20-34) p.u. (p < 0.007). In both volunteers, the microcirculatory flow responded to the vascular challenge, resulting in flow changes related to the cuff pressure (45-27 and 14-8 p.u.). This method demonstrated that it may be possible to assess the microcirculation through intact bandages, without the need to place any sensors at the skin-bandage interface.

Specific growth factors and the healing of chronic wounds

Part II of this two-part review focuses on the function of specific growth factors in wound healing and considers the results of clinical trials of their use in chronic wounds.

A dynamic regulator: the role of growth factors in tissue repair

Growth factors have the potential to improve wound healing during the three main phases of wound repair. This review, the first in a two-part series, explains how they do this.

Arteriovenous malformation of the forearm as a result of a persistent median artery

Most arteriovenous malformations usually arise from pre-existing named vessels. We report an unusual variant of an arteriovenous malformation. An 18-year-old man presented with a painful swelling of the right forearm. Arteriograms suggested branches of the anterior interosseous artery were feeding the malformation. Operative findings however, revealed the presence of a persistent median artery, which was contributing branches to the swelling.

Mixed connective tissue disease presenting to the acute hand service

Mixed connective tissue disease is an autoimmune condition with a specific autoantibody. It commonly presents as Raynaud's disease and the patient is usually treated symptomatically. We present an unusual case of mixed connective tissue disease presenting as a acutely inflamed joint with considerable bony destruction.

Circulating levels in serum of total sialic acid, lipid-associated sialic acid, and fucose in precancerous lesion and cancer of the oral cavity

Total sialic acid (TSA), lipid-associated sialic acid (LASA), and fucose were estimated in sera of 35 patients with precancerous lesion of the oral cavity, 68 patients with cancer of the oral cavity, and 25 age- and sex-matched non-chewers of both tobacco and betal nut and nonsmokers as controls. Significant elevation in the serum levels of TSA and LASA were observed in patients with the precancerous and cancer lesions when compared with the controls. Serum TSA levels were elevated significantly in patients with cancer when compared with those with precancerous lesions. Circulating TSA and LASA levels were found to reflect tumor burden and correlated well with stage of the disease. However, serum fucose levels did not show an increase corresponding to stage of the disease. The results suggests that combined evaluation of these markers may be useful in predicting early malignant change and also in assessing the spread and invasiveness of the disease in cancer of the oral cavity.

Effects of lithium chloride as a potential radioprotective agent on radiation response of DNA synthesis in mouse germinal cells

Mouse spermatogonial germ cells are highly sensitive to ionizing radiation. Lithium salts are reported to stimulate the postirradiation recovery of hematopoietic marrow cells. We have, therefore, examined whether administered lithium chloride (LiCl) would also be able to protect the mouse germinal cells against radiation injury. Taking DNA synthesis as an endpoint, our results show that the testicular DNA-specific activity in irradiated mice was higher by 61% on average when they had been pretreated with LiCl both 24 h and 1 h prior to gamma-irradiation (2.0 Gy). It was also observed that the DNA synthetic activity in the germinal cells fully recovered after LiCl pretreatment at doses of 40 mg per kg body weight prior to total body irradiation of 0.05-0.25 Gy, whereas at doses of 0.5-6.0 Gy, following the same procedure of LiCl pretreatment, only an incomplete recovery was observed. The dose reduction factor for LiCl is 1.84. The current findings indicate that pretreatment with LiCl provides considerable protection against radiation damage in mouse spermatogonia.

Serum carotene, vitamin A, and vitamin C levels in breast cancer and cancer of the uterine cervix

Levels of carotene, vitamin A, and vitamin C measured in the serum of patients with cancer of the breast and uterine cervix were compared with levels in healthy controls and patients with benign diseases of the breast and cervix. Serum ascorbate levels were significantly lower in patients with benign diseases of the breast and cervix than in controls. In cancer patients, there was a significant trend of lower serum vitamin levels with increasing stage of the disease.

Oxidative stress in radiation-induced interstitial pneumonitis in the rat

The involvement of free radical metabolism in the pathogenesis of interstitial pneumonitis was investigated in an animal model. Male Wistar rats were irradiated at the thoracic region by gamma-rays from a 60Co source. Histopathological examination confirmed that 50% of the rats developed pneumonitis between 2 and 8 weeks following a single dose of 14 Gy. Parallel biochemical studies in the lung of these rats showed that mitochondria and microsomes had higher levels of lipid peroxidation. In the cytoplasmic fraction of the lung the activities of superoxide dismutase and catalase were markedly reduced in the pneumonitic rat. In lung mitochondria, however, the levels of these two enzymes were not significantly altered. On the contrary, lipid peroxidation and superoxide dismutase, as well as catalase activities in lung tissue in the non-pneumonitic group of the irradiated rat were comparable with that of control animals. The results indicate that free radical-induced oxidative stress following thoracic irradiation may be one of the causative factors in the development of interstitial pneumonitis.

Vitamin and provitamin A levels in epithelial cancers: a preliminary study

A major physiological role of retinoids is the regulation of epithelial and epidermal cell differentiation. A total of 285 patients with clinically and histopathologically confirmed diagnosis of various carcinomas (untreated) were selected for the study. The control values of serum beta-carotene and vitamin A levels were established from 50 subjects free of any known pathology. The controls were matched for age and sex. The mean serum levels of beta-carotene and vitamin A have shown a significant difference (p less than 0.001) in all the cancers compared with the controls. In cancer of the oral cavity, the males showed significantly lower levels (p less than 0.01) compared with their female counterparts. In cancer of the lung, however, the mean serum levels of beta-carotene and vitamin A were higher in males compared with females (p less than 0.02). Our results suggest a possible association between vitamin A and epithelial cancer, but whether the deficiency is the cause of the disease or if it is due to the tumor remains unknown.

Quantitation of free kappa light chains in serum and urine using a monoclonal antibody based inhibition enzyme-linked immunoassay

The murine monoclonal antibody K-1-21 with specificity for free but not heavy chain-associated kappa chains was used to develop an inhibition enzyme immunoassay for quantitation of free kappa chains in serum and urine. The assay utilizes a biotin conjugate of the monoclonal antibody and has an effective working concentration range of 0.5-50 micrograms/ml free kappa chain. Normal serum and urine yielded mean values of 1.2 and 4.9 micrograms/ml respectively using this assay system. Serum levels in patients with kappa chain myelomatosis ranged from 2 to 1700 micrograms/ml while serum from patients with lambda chain malignancies exhibited normal free kappa chain levels. The importance of the ability to readily quantitate light chains in serum was demonstrated by the finding in one patient of an absence of free kappa chains in the urine despite elevated levels of serum kappa chains. A significant drop in serum-free kappa chain levels was observed in this patient following a course of chemotherapy. The assay should prove valuable in the diagnosis, prognosis and monitoring of B cell neoplasias characterized by free kappa light chain secretion.