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Small cell lung carcinoma (SCLC): the angiogenic phenomenon
Marco Lucchi1, Alfredo Mussi, Gabriella Fontanini
1Cardiac and Thoracic Department, Division of Thoracic Surgery, University of Pisa, Via Paradisa 2, Italy. m.lucchi@med.unipi.it
Summary
Tumor angiogenesis, measured by microvessel count (MVC) and vascular endothelial growth factor (VEGF), correlates with prognosis in surgically treated small cell lung cancer (SCLC). VEGF expression is an independent prognostic factor, suggesting SCLC as a model for antiangiogenic drug trials.
Area of Science:
- Oncology
- Cancer Biology
- Surgical Pathology
Background:
- Tumor angiogenesis, quantified by microvessel count (MVC), and its mediators like vascular endothelial growth factor (VEGF) are linked to metastasis in non-small cell lung cancer (NSCLC).
- Small cell lung cancer (SCLC) is rarely treated surgically, limiting biological characterization studies.
- This study reviews surgical SCLC cases, focusing on angiogenic markers and their correlation with disease stage and patient prognosis.
Purpose of the Study:
- To investigate the role of tumor angiogenesis in surgically treated SCLC.
- To correlate microvessel count (MVC) and vascular endothelial growth factor (VEGF) expression with disease stage and overall survival in SCLC patients.
- To determine if VEGF expression is an independent prognostic factor in SCLC.
Main Methods:
- Retrospective analysis of 87 SCLC patients who underwent primary surgery and adjuvant chemotherapy (1980-1998).
- Microvessel count (MVC) assessed using anti-CD34 antibodies; VEGF and p53 protein expression evaluated via immunohistochemistry.
- Correlation of MVC, VEGF, and p53 with clinicopathological parameters, overall survival (OS), and disease stage.
Main Results:
- A median follow-up of 109.6 months revealed 37 patients alive and well.
- Metastatic nodal involvement and advanced disease stage were associated with worse overall survival (OS).
- Both MVC and VEGF protein expression significantly impacted survival (P<0.001 and P=0.0008, respectively). VEGF was an independent prognostic factor on multivariate analysis (P=0.003).
Conclusions:
- Tumor angiogenesis, indicated by MVC and VEGF, plays a role in SCLC metastasis and prognosis, similar to NSCLC.
- SCLC exhibits higher vascularization than NSCLC.
- VEGF expression is a significant independent prognostic factor in SCLC, supporting its potential as a target for antiangiogenic therapies.