Vascular endothelial growth factor-C associated with computed tomography used in the diagnosis of lymph node metastasis of bladder carcinoma.

BACKGROUND AND AIMS

Vascular endothelial growth factor C (VEGF-C) has been demonstrated to stimulate the growth of lymphatic vascular endothelium. The purpose of this study is to determine whether VEGF-C associated with computed tomography (CT) has a relationship with lymph node metastasis in bladder transitional cell carcinoma (BTCC).

METHODS

One hundred twenty seven cases of BTCC were studied: first, both plain and enhanced CT scans of abdomen and pelvis were performed preoperatively; second, VEGF-C protein expressions in tumor cells were tested by immunohistochemistry postoperatively; and finally, detailed pathological findings for lymph node metastasis were recorded.

RESULTS

VEGF-C expressions in tumor bladder cells were significantly higher than those in normal bladder epithelium. In the group of BTCC-positive, VEGF-C was significantly correlated with lymph node metastasis (p <0.01). Sensitivity, specificity and accuracy of VEGF-C in the diagnosis of lymph node metastasis of bladder carcinoma were 87.0, 67.9, and 74.8%, respectively. Sensitivity, specificity and accuracy of CT were 47.8, 80.2, and 68.5%, respectively. When VEGF-C visually correlated with CT scan in the detection of lymph node metastasis, sensitivity was 91.3%; specificity was 84.0% and accuracy was 86.6%.

CONCLUSIONS

Positive VEGF-C was significantly correlated with lymph node metastasis of bladder carcinoma. VEGF-C expression in biopsy specimens may be beneficial in predicting pelvic lymph nodes. It can improve accuracy when combined with CT.