Objective: Angiogenesis is one of the crucial steps in various solid tumor growth and metastasis. However, there are limited data regarding the clinical and prognostic significance of serum vascular endothelial growth factor levels per platelet count in unresectable advanced gastric cancer compared with early gastric cancer and healthy volunteers.
Methods: A total of 181 gastric cancer patients were included and control serum samples were acquired from 113 healthy volunteers. The levels of serum vascular endothelial growth factor were measured using human vascular endothelial growth factor quantitative enzyme-linked immunosorbent assay. Survival curves were calculated using the Kaplan-Meier method and survival comparisons were made by the log-rank test in metastatic gastric cancer.
Results: There was a significant correlation between serum vascular endothelial growth factor levels and differentiation of tumor (P = 0.014), stage (P = 0.036). The overall survival (P = 0.0432) and the progression-free survival (P = 0.0116) were significantly shorter in patients with high serum vascular endothelial growth factor per platelet count (≥1.626 pg/10(6)). In the multivariate analysis, the presence of peritoneal carcinomatosis (P = 0.039), serum vascular endothelial growth factor per platelet (P = 0.005) were found to be significantly associated with poor progression-free survival.
Conclusions: This study demonstrates that serum vascular endothelial growth factor per platelet count is correlated with poor overall survival and progression-free survival in patients with advanced gastric cancer.