The expression of vascular endothelial growth factor (VEGF)/ endostatin (ES) and VEGF receptor 2 (VEGFR2)/ES is associated with NSCLC prognosis*

Abstract

Abstract Objective The aim of our study was to detect the expression of angiogenesis inhibitory proteins and angiogenesis promotive proteins in the postoperative tumor tissue of non-small cell lung cancer (NSCLC) patients. We also investigated the relationship of protein expression with clinical characteristics and prognosis. Methods We examined the expression of vascular endothelial growth factor (VEGF), VEGF receptor 2 (VEGFR2), and endostatin (ES) proteins in 255 specimens resected from NSCLC patients, using immune histochemistry (IHC). We then evaluated the relationships between the expression of the three proteins and clinical characteristics such as stage, histological type, differentiation, gender, tobacco use, and age. According to the value of VEGF/ES, we divided the cohort into angiogenesis-promoting group A, angiogenesis-inhibiting group A, and balance group A. The survival differences in the three groups were evaluated to determine the prognostic value of VEGF/ES. Similarly, we tested the prognostic value of VEGFR2/ES. Results VEGF-positive expression was observed in 93 patients (36.4%). VEGF expression was not correlated with the clinical characteristics. VEGFR2-positive expression was observed in 103 patients (40.4%). The expression of VEGFR2 was correlated with the clinical stage (χ 2 = 21.414, P = 0.045) and histological type (χ 2 = 26.911, P = 0.008). ES-positive expression was observed in 140 patients (54.9%). The expression of ES was correlated with the clinical stage (χ 2 = 26.504, P = 0.009). When evaluating the prognostic values of VEGF/ES and VEGFR2/ES, the prognosis of the angiogenesis balance group was similar to that of the angiogenesis-inhibiting group. The minimum survival time was observed in the angiogenesis-promoting group. Conclusion VEGF/ES and VEGFR2/ES in resected tumors have prognostic value in postoperative NSCLC patients. The survival time of the population with predominant angiogenic factors was short. List of abbreviations VEGF (vascular endothelial growth factor); VEGFR2 (vascular endothelial growth factor receptor 2); ES (endostatin); NSCLC (non-small cell lung cancer); IHC (immunohistochemical); EGFR (epidermal growth factor receptor); ALK (anaplastic lymphoma kinase); ROS1 (c-ros oncogene 1 receptor kinase); TNM (tumor, lymphnode, metastasis); HR (hazard ratio); SCLC (small cell lung cancer); SFDA (State Food and Drug Administration); ERK (extracellular regulated protein kinases); MAPK (mitogen-activated protein kinase)