Incipient Angiogenesis in Barrett’s Epithelium and Lymphangiogenesis in Barrett’s Adenocarcinoma

Abstract

BE is strongly neovascularized not eroded. This novel concept of a molecular mechanism of the origin of BE might emphasize why precancerous BE can give rise to the more cancerous dysplasia and Barrett's adenocarcinoma stages. In addition, adenocarcinoma cells induce lymphangiogenesis. The new lymphangiogenic vessels might provide a systemic route for adenocarcinoma cells to invade circulation and induce lymph node metastasis.

Angiogenesis in pre-malignant conditions

“…In a large series of Barrett's oesophagus and associated adenocarcinoma, angiogenesis was markedly increased in pre-malignant lesions, which correlated with VEGF expression. Vascular endothelial growth factor expression was elevated in epithelial cells with strong VEGFR-2 expression on associated vessels (Auvinen et al, 2002). Evidence of enhanced angiogenesis was also demonstrated in precursor lesions of oesophageal SCC accompanied by elevated VEGF and TP levels (Kitadai et al, 2004).…”

Vascular endothelial growth factors C and D and lymphangiogenesis in gastrointestinal tract malignancy

“…Vascular endothelial growth factor-C expression is associated with neoplastic progression in the oesophageal mucosa. Using immunohistochemical detection, normal oesophageal mucosa does not express VEGF-C although there is an increase in expression in Barrett's epithelium as it progresses through dysplasia to adenocarcinoma, and this is paralleled by a similar increase in VEGFR3 expression on lymphatic vessels (Auvinen et al, 2002).…”

Activation of Growth Factor Receptors in Esophageal Cancer—Implications for Therapy

“…This was also indicated in work by Kitadai et al [117], who demonstrated an initial increase in vessel density and enhanced expression of VEGF and platelet-derived endothelial cell growth factor, another angiogenic factor, in dysplastic epithelium of esophageal squamous cell carcinomas. Auvinen et al [118] compared Barrett's dysplasia with normal esophageal mucosa, finding that Barrett's-specific glandular epithelium secretes VEGF-A, in addition to a mixture of sialomucin and sulfated mucins. The receptor of VEGF-A (VEGFR-2) is strongly expressed on angiogenic blood vessels feeding the Barrett's epithelium.…”