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Serum VEGF (sVEGF) Clinical Research

Studies have shown that serum VEGF (sVEGF) levels in cancer patients are significantly higher than in control subjects. Karayiannakis et al evaluated the clinical usefulness of preoperative and postoperative sVEGF levels in 58 newly diagnosed gastric cancer patients, and 61 age- and sex-matched control subjects. Those with prior chemotherapy, radiotherapy, or blood transfusions were excluded. Median follow-up time was 11 months (range: 2 to 46 months).1 The association between serum levels and tissue VEGF expression was not evaluated in this study.1

In this study, preoperative sVEGF levels in gastric cancer patients were significantly higher than in controls (P<0.0001), significantly correlated with disease stage and increased as the disease stage increased (P=0.01), and were elevated in patients with distant metastases compared with those without metastatic disease (P=0.004).1

sVEGF levels were significantly reduced following surgical resection (P=0.0005)1

VEGF in the autocrine loop

Significant differences in median sVEGF levels after radical tumor resection (ο) and following unresectable disease (). Statistically significant differences vs preoperative values are shown (*). Fifty-eight consecutive patients with newly diagnosed and histologically confirmed gastric cancer were included in the analysis. Fifty cases belonged to primary gastric cancer whereas, in 8 cases, the tumor developed in the gastric remnant many years after initial resectional surgery. The study population consisted of 38 men and 20 women with a median age of 68 years. Control subjects included 61 age- and sex-matched healthy volunteers.

Adapted from Karayiannakis AJ, Syringos KN, Polychronidis A, et al. Ann Surg. 2002;236:37-42.
Figure 1.

Elevated sVEGF levels were associated with reduced rate of survival (P<0.0001)1

VEGF in the autocrine loop

Significantly lower survival rate in patients with elevated VEGF levels (>533 pg/mL) vs nonelevated VEGF levels (P<0.0001) (N=58). Fifty cases belonged to primary gastric cancer whereas, in 8 cases, the tumor developed in the gastric remnant many years after the initial resectional surgery. The study population comprised 38 men and 20 women with a median age of 68 years. Control subjects included 61 age- and sex-matched healthy volunteers.1

This study also revealed a significant association between sVEGF levels preoperatively and overall survival. sVEGF levels were found to act as an independent prognostic factor for overall survival in a multivariate analysis.1

As for the source of sVEGF, this study implicates the primary tumor in producing and releasing soluble VEGF fragments into serum. The authors suggest potential uses of sVEGF for evaluating surgery and monitoring tumor recurrence, which require further study.1

Adapted from Karayiannakis AJ, Syringos KN, Polychronidis A, et al. Ann Surg. 2002;236:37-42.
Figure 2.

Reference:
1.
Karayiannakis AJ, Syrigos KN, Polychronidis A, et al. Ann Surg. 2002;236:37-42. PMID: 12131083
 
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