Primary Tumor Vascularity, HIF-1α and VEGF expression in vulvar squamous cell carcinomas: their relationships with clinicopathological characteristics and prognostic impact

Abstract

BackgroundIncreased vascularity is a crucial event in the tumor progression and has prognostic significance in various cancers. However, the ultimate role of angiogenesis in the pathogenesis and clinical outcome of vulvar carcinoma patients is still not settled.MethodsTumor vascularity using CD34 stained slides measured by Chalkley counting method as well as hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) immunoexpression was examined in 158 vulvar squamous cell carcinomas. Associations between vascular Chalkley count, HIF-1α and VEGF expression and clinicopathological factors and clinical outcome were evaluated.ResultsHigh CD34 Chalkley count was found to correlate with larger tumor diameter (P = 0.002), deep invasion (P < 0.001) and HIF-1α (P = 0.04), whereas high VEGF expression correlate significantly with poor tumor differentiation (P = 0.007). No significant association between CD34 Chalkley counts and VEGF expression and disease-specific survival was observed. High HIF-1α expression showed better disease specific survival in both univariate and multivariate analyses (P = 0.001).ConclusionsA significant association between high tumor vascularity and larger tumor size as well as deeper tumor invasion suggests an important role of angiogenesis in the growth and progression of vulvar carcinomas. HIF-1α expression in vulvar carcinomas was a statistically independent prognostic factor.

Expression of cluster of differentiation 34 and vascular endothelial growth factor in breast cancer, and their prognostic significance

“…Ni et al (28) reported that VEGF expression in 75 patients with breast cancer was negatively correlated with survival time, indicating that VEGF may be a malignant phenotype of breast cancer, with increased expression predicting a poor prognosis. By contrast, a study conducted by Dhakal et al (8) identified that VEGF expression is associated with the differentiation of squamous cell carcinoma of the vulva, but not with patient survival. Similarly, a previous study determined that VEGF expression is not associated with clinicopathological factors or survival in patients with colorectal cancer (9).…”

“…Recently, the associations between CD34 and VEGF expression, and the clinicopathological characteristics of patients with cancer have been reported; however, the association between these associations and the survival of patients with cancer have rarely been reported. It has previously been demonstrated that the expression of CD34 and VEGF is of great importance for determining the prognosis of cancer patients (4-7), however, certain studies have argued that there is no significant association between the expression of CD34 and VEGF, and the survival of patients with cancer (8,9). Therefore, the aim of the present study was to analyze the association between the expression of CD34 and VEGF, and the survival of patients with breast cancer, in order to identify the clinical significance of these two indicators in determining the prognosis of patients with breast cancer.…”

Intravoxel Incoherent Motion Combined With Dynamic Contrast‐Enhanced Perfusion MRI of Early Cervical Carcinoma: Correlations Between Multimodal Parameters and HIF‐1α Expression

“…In this study, a low molecular weight contrast agent (Gd‐DTPA) was used, which might have some influence on the assessment of the K trans value. Second, HIF‐1α expression was observed not only in tumor cells but also in the stromal component of the tumor, but this study observed the HIF‐1α expression only in tumor cells, just as in many previous studies . Therefore, the correlation between multiple imaging parameters and HIF‐1α expression in the stromal component of the cervical tumor is unclear and needs to be further investigated.…”

“…The expression of HIF‐1α was classified into low‐expression and high‐expression groups on the basis of the summation of positive score and strength score. Only when the HIF‐1α positively stained tumor cells accounted for more than 50% of the total tumor cells and the coloring strength score was ≥2 was the expression of HIF‐1α scored as high‐expression, while the expression of HIF‐1α that did not satisfy these criteria was scored as low‐expression …”

“…Only when the HIF-1α positively stained tumor cells accounted for more than 50% of the total tumor cells and the coloring strength score was ≥2 was the expression of HIF-1α scored as high-expression, while the expression of HIF-1α that did not satisfy these criteria was scored as low-expression. 15,16 The slides were stained with hematoxylin and eosin (H&E) according to standard histologic protocols. The percentage of stroma was determined according to a previous study by us.…”