Pleural Effusion VEGF Levels As A Prognostic Factor Of Malignant Pleural Mesothelioma

Abstract

2Corresponding author's email: ctabata@hyo-med.ac.jp Malignant pleural mesothelioma (MPM) is an aggressive malignant tumor of mesothelial origin associated with asbestos Rationale: exposure. MPM has a limited response to conventional chemotherapy and radiotherapy so early diagnosis of MPM is very important. Vascular endothelial growth factor (VEGF), a potent mitogen for the vascular endothelium, is also known to be an autocrine growth factor for MPM. Here, we investigated the pleural effusion VEGF levels in patients with MPM and compared them to those of a population with a non-malignant pleuritis or lung cancer involving malignant pleural effusion.The pleural effusion VEGF concentrations were measured in 46 MPM patients and 45 individuals with non-MPM individuals (25 Methods: individuals with non-malignant pleural effusions, and 20 individuals with lung cancer involving malignant pleural effusion).We demonstrated that patients with MPM had significantly higher pleural effusion VEGF levels than a population with Results: non-malignant pleuritis or lung cancer involving malignant pleural effusion, and the patients with advanced stage MPM showed higher levels of VEGF than the early stage MPM patients. The difference in overall survival between the groups with pleural effusion VEGF levels lower and higher than the assumed cutoff of 2000 pg/ml was significant.Our data suggest that the pleural effusion VEGF concentration could be useful as an aid for the diagnosis of MPM and as a Conclusions: prognostic factor. This abstract is funded by: None Am J Respir Crit Care Med 183;2011:A4810 Internet address: www.atsjournals.org Online Abstracts Issue

Differential expression of vascular endothelial growth factor-A, -C and -D for the diagnosis and prognosis of cancer patients with malignant effusions

“…The prognostic significance of pVEGF-A has been estimated in several previous studies (13,14). Hirayama et al followed 28 malignant pleural mesothelioma patients closely for up to 600 days (13) and demonstrated that a VEGF level of >2,000 pg/ml was a significant predictor of patient survival (13).…”

“…VEGF-A levels in malignant effusions were found to be significantly increased compared with those in non-malignant effusions, indicating that this difference may aid in the differentiation between malignant and non-malignant effusions (11,12). The altered expression of VEGF-A has been reported to be associated with the poor prognosis of various types of human cancer (13,14). Multiple clinical studies have also demonstrated the potential benefit of VEGF-A inhibition in patients with malignant effusions (15).…”

Endostar inhibits ascites formation and prolongs survival in mouse models of malignant ascites

“…In addition a VEGF blockade has been identified to lead to marked reductions in ascites formation (1,5,8,19). Cancer-associated effusions contain significantly more VEGF than those resulting from inflammatory diseases, which suggests that VEGF levels are an independent and statistically significant prognostic indicator of survival (20,21). The results of a previous study revealed that hemorrhagic malignant effusions (RBC count, >1x10 4 /µl) exhibit significantly higher VEGF levels (1,942 pg/ml) compared with non-hemorrhagic effusions (202 pg/ml) (P= 0.016) in malignant patients (21).…”

“…VEGF has an important role in increasing vascular permeability during malignant ascites formation (1)(2)(3)(4)(5). Previous studies have revealed that high concentrations of VEGF are detected in the hydrothorax and ascites fluid of cancer patients (20)(21)(22). The vascular permeabilizing activity of VEGF has been reported to be 50,000 times more potent than histamine.…”

Role of Inflammation and Angiogenic Growth Factors in Malignant Mesothelioma

“…On the other hand, VEGF levels in serum or pleural effusions of MM patients are higher than those found in patients with nonmalignant pleuritis or lung cancer involving malignant pleural effusions. Further, in MM patients elevated serum or pleural effusion levels of VEGF correlate with a worse prognosis and may also contribute to increase resistance to chemotherapy (Hirayama et al, 2011;Yasumitsu et al, 2010;Zebrowski et al, 1999). In fact, VEGF status has proved to be of value in predicting the effectiveness of radiotherapy and chemotherapy on different cancers (Choi et al, 2008;Kumar et al, 2009;Toi et al, 2001).…”