VEGF and Endostatin Levels in Wound Fluid and Plasma after Breast Surgery

Abstract

Angiogenesis is essential for wound repair after surgical trauma. Vascular endothelial growth factor (VEGF) and endostatin are endogenous angiogenic factors involved in the initiation and completion of angiogenesis. The aim of this study was to examine the local and systemic VEGF and endostatin profiles in patients undergoing surgery for benign and malignant breast processes. A total of 16 patients with or without cancer underwent breast surgery. Group I: eight patients with primary breast cancer underwent a simple or radical mastectomy according to Madden including dissection of axillary lymph nodes. Group II: eight healthy female-to-male transsexuals underwent subcutaneous mastectomy. VEGF and endostatin levels in plasma and wound fluid were determined. In both groups VEGF levels in wound fluid were significantly higher compared to postoperative plasma levels, whereas wound fluid endostatin levels were lower than plasma levels and decreased progressively after surgery. In both groups plasma VEGF and endostatin levels did not change significantly before and after surgery. The local VEGF increase and endostatin decrease observed immediately after surgery appears to be a physiological response to operative trauma, which can be studied more profoundly in locally generated fluid than in blood. This process did not seem to be influenced by the type of process (cancerous or non-cancerous) involved in the surgical intervention.

Plasma interleukin-8 levels are persistently elevated for 1�month after minimally invasive colorectal resection for colorectal cancer

“…There is evidence that the healing wounds may be the source of the long duration increase in plasma VEGF levels noted after surgery, mentioned above. Wound levels of VEGF have been found to be much higher than plasma levels in a variety of surgical patients (33)(34)(35). The authors are currently conducting several studies investigating plasma and wound levels of the above listed proteins after MICR and hope to settle this issue.…”

Plasma chitinase 3-like 1 is persistently elevated during first month after minimally invasive colorectal cancer resection

“…The same research team, in a study of mastectomy patients noted that on POD 4 wound VEGF levels were between 23 and 32 times greater than serum levels [46] . There is also strong preliminary unpublished data of the authors suggesting that wound levels of ANG2, and MMP2 are elevated and many times higher than plasma concentrations after MICR (plasma levels also elevated 3-4 wk).…”

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“…For example, in wound healing, VEGF concentration in the wound fluid is several fold the plasma or serum concentration (Hormbrey et al, 2003;Karayiannakis et al, 2003;Wu et al, 2003;Di Vita et al, 2006). In bone marrow fluid, VEGF levels increase from 1.5 to 4 pM in acute leukaemia patients (Ye et al, 2003).…”