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Expression of vascular endothelial growth factor-A in human lymph node metastases of prostate cancer

A. Hazem Ismail, Waleed Altaweel, Simone Chevalier, Wassim Kassouf, Armen G. Aprikian

Urologic Oncology Research Group, Department of Surgery, Urology Division, McGill University Health Center and The Montreal General Hospital Research Institute, Montreal, Quebec, Canada
Address correspondence to Dr. Armen G. Aprikian, McGill University Health Center, The Montreal General Hospital,1650 Cedar Avenue, Montreal, Quebec, H3G 1A4 Canada

Canadian Journal of Urology 2004, 11(1), 2146-2150.

Abstract

Introduction: Vascular endothelial growth factors (VEGF) figure among the most potent angiogenic factors identified. Local as well as serum VEGF-A over-expression has been correlated with metastasis in prostate cancer. However, little is known on VEGF-A expression in prostate cancer metastases themselves. Our objective was to assess VEGF-A expression in relation with angiogenesis in prostate cancer lymph node metastases.
Methods: Fifty-four lymph node metastatic specimens obtained from 32 patients were included in this study. All nodes were of prostate cancer origin as confirmed by positive PSA staining. Immunohistochemistry was performed to identify VEGF-A expressing cancer cells. Consecutive sections were stained for angiogenesis using von Willebrand factor (vWF) as a marker and neuroendocrine (NE) differentiation using chromogranin-A and serotonin antibodies. VEGF-A expressing cells were recorded (at 100x magnification) and expression was classified as: 1-Negative (0 cells), 2-Low (1-5 positive cells/high power field (HPF)), and 3-High (>5 cells/HPF).
Results: VEGF staining was identified mainly in NE cells and endothelial cells. Of the 32 patients, VEGF expression was positive in 22 (69%), with 2 patients (6%) showing high levels and 20 patients (63%) classified as low. No VEGF expression was noted in 10 patients (31%). Of the 54 metastatic lymph node specimens examined, VEGF expression was positive in 31 (57%). VEGF-A stained NE cells did not correlate with blood vessels as revealed by vWF expression in consecutive sections (p=0.9).
Conclusion: VEGF-A is preferentially expressed in NE cells of prostate cancer lymph node metastases and appears unrelated to angiogenesis. These observations support the role played by NE-expressing VEGF-A in the development of metastatic prostate cancer.

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