Pretreatment serum levels of bFGF and VEGF and its clinical significance in endometrial carcinoma

Abstract

Objective: In this study, we examined the frequency of serum elevation as well as the prognostic significance of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in endometrial cancer (EC) type I and a biologically aggressive variant of EC type II.

Materials and methods: Pretreatment serum levels of bFGF and VEGF were evaluated by commercially available enzyme-linked immunosorbent assay (ELISA) for cancer patient samples with type I EC (n=70) and type II EC (n=64) and compared to a cohort of normal individuals (n=64). Values were correlated with clinicopathological characteristics and outcome.

Results: Median pretreatment VEGF values were 470.4pg/ml (range, 164.3-598.4pg/ml) for type I EC, 608.8pg/ml (range, 354.2-783.6pg/ml) for type II of EC patients and 215.6pg/ml (range, 128.3-332.9pg/ml) for normal healthy subjects (p<0.001). Elevated serum VEGF concentration correlated significantly with advanced FIGO stage in type II EC (p=0.011). Median values of bFGF were 10.7pg/ml (range, 0.5-22.5pg/ml) for type I EC, 21.2 (range, 0.5-62.4pg/ml) for type II EC and 1.1 (range, 0-7.2pg/ml) in controls (p<0.0001). The pretreatment bFGF levels correlated with advancing tumor stages in types I and II EC (p <0.05). Multivariate analysis with Cox proportional hazard regression models revealed that high bFGF serum level correlated with shorter overall survival (OS) in type I EC (HR, 0.39, p<0.001) and in type II EC (HR, 0.47, p=0.01) and disease-free survival (DFS) (HR, 0.53, p=0.03 and HR, 0.51, p=0.02, respectively).

Conclusion: High preoperative bFGF levels predict a poor prognosis in patients with EC, and the prognostic value is independent of established prognostic parameters. These data suggest that bFGF might potentially serve as a marker in prognosis and offer a possibility to individualize treatment regimen.