Vascular endothelial growth factor receptor-3 is a favorable prognostic factor in advanced gastric carcinoma

Vascular endothelial growth factor receptor (VEGFR)-3 is a receptor for VEGF-C and D and is implicated in the development of lymphatic vessels and metastasis. The purpose of this study was to investigate the expression of VEGFR-3 and its clinicopathological significance in primary gastric carcinoma (GC). Pathological and clinical findings from 109 GC cases were reviewed and VEGFR-3 expression was examined using immunohistochemistry. The clinicopathological implications of VEGFR-3 expression were analyzed statistically. VEGFR-3 expression was evaluated for intensity (0-3) and proportion (0-100%). A total score was obtained by multiplying the intensity by the proportion (0-300). A total score of 82 or more was considered positive for VEGFR-3. Of the 109 patients with GC, 19 (17.4%) were positive for VEGFR-3. VEGFR-3 expression was associated with Lauren classification (68.4% for intestinal type, 31.6% for diffuse type, p=0.058). It was more frequent in early gastric cancer (EGC), 28.0% in EGC, 16.2% in advanced gastric carcinoma (AGC), though this difference was not statistically significant. In 78 patients with AGC, VEGFR-3 expression was associated with good overall survival (p=0.052). In a multivariate analysis, the pTNM stage and VEGFR-3 were independent prognostic factors (OR=3.35, p=0.002 for pTNM stage; OR=0.23, p=0.044 for VEGFR-3). However, the expression of VEGFR-3 in EGC was not correlated with overall survival. In conclusion, the expression of VEGFR-3 was associated with the intestinal type (based on Lauren classification) and may be a favorable prognostic factor in AGC.