Association Between Color Doppler Vascularity Index, Angiogenesis-Related Molecules, and Clinical Outcomes in Gastric Cancer

  • Dr Chiung Nien Chen, National Taiwan University Hospital, Department of Surgery, Taiwan
  • Dr Jen-Jen Lin, Ming Chuan University, Department of Applied Statistics and Information Science, Taiwan
  • Hsinyu Lee, National Taiwan University, Department of Life Science, Taiwan
  • Yunn-Ming Cheng, National Taiwan University Hospital, Department of Pathology, Taiwan
  • King Jen Chang, National Taiwan University Hospital, Department of Surgery, Taiwan
  • Fon-Jou Hsieh, National Taiwan University Hospital, Department of Obstetrics and Gynecology, Taiwan
  • Po-Huang Lee, National Taiwan University Hospital, Department of Surgery, Taiwan

    • Purpose: This study was conducted to evaluate the correlation between color Doppler vascularity index (CDVI), clinical outcomes and five angiogenesis-related molecules including vascular endothelial growth factor (VEGF), placenta growth factor (PlGF), cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), and calreticulin (CRT) in gastric cancer, and to develop an effective model selected from these five molecules to predict patient survival.
    Patients and Methods: CDVI could be obtained preoperatively by transabdominal ultrasound from 30 patients. Enzyme immunoassay was adopted to determine protein level of VEGF and PlGF, and immunohistochemistry was used to detect COX-2, iNOS and CRT expression. Correlation between CDVI and five individual molecules was assessed. Multiple molecules model was developed using classification and regression tree (CART) analysis from five molecules, and was tested for patient survival in another 45 patients.
    Results: CDVI was significantly correlated with patient survival (p=0.00907) and absolute number of metastatic lymph nodes (p=0.01). There was no significant association between CDVI and any individual molecule. The model, developed by CART consisting of VEGF and PlGF, could differentiate high and low CDVI and survival in testing group (p=0.00257).
    Conclusions: CDVI was associated with lymph node metastasis, combined VEGF and PlGF expression status and patient survival in gastric cancer.