Immunohistochemical expression and prognostic significance of VEGF-C in well-differentiated thyroid cancer

S Ceric; T Ceric; N Pojskic; N Bilalovic; J Musanovic; E Kucukalic-Selimovic

doi:10.4183/aeb.2020.409

Immunohistochemical expression and prognostic significance of VEGF-C in well-differentiated thyroid cancer

Acta Endocrinol (Buchar). 2020 Oct-Dec;16(4):409-416. doi: 10.4183/aeb.2020.409.

Authors

S Ceric¹, T Ceric², N Pojskic³, N Bilalovic⁴, J Musanovic⁵, E Kucukalic-Selimovic¹

Affiliations

¹ University Clinical Center Sarajevo. Bosnia and Herzegovina - Department of Nuclear Medicine and Endocrinology - Sarajevo, Bosnia and Herzegovina.
² University Clinical Center Sarajevo. Bosnia and Herzegovina - Department of Oncology - Sarajevo, Bosnia and Herzegovina.
³ University of Sarajevo, Institute for Genetic Engineering and Biotechnology, Sarajevo, Bosnia and Herzegovina.
⁴ University Clinical Center Sarajevo. Department of Pathology and Cytology, Sarajevo, Bosnia and Herzegovina.
⁵ University of Sarajevo, School of Medicine, Department of Biology and Human Genetics, Sarajevo, Bosnia and Herzegovina.

Abstract

Context: Neoangiogenesis and lymphangio-genesis are essential for the growth of tumor and progression of malignancy.

Objective: The study examined the significance of VEGF-C expression in comparison to classical prognostic factors in differentiated thyroid carcinoma (DTC), as well as an independent prognostic marker in DTC.

Design: The study included 81 patients with DTC allocated in two groups according to the type of cancer (follicular versus papillary) and then compared to expression of VEGF-C and clinicopathological features.

Methods: Expression of VEGF-C was identified with anti-VEGF-C antibody using tris-EDTA buffer Antigen Retrieval Protocol. Each specimen was scored with a semi-quantitative score system (H-score).

Results: The analysis of T staging system showed a linear correlation between the size of a tumor, expression of VEGF-C and recurrence of a disease, with a statistical significance (p < 0.0001). There was a clear and significant correlation between VEGF-C expression and T stage in patients with papillary carcinoma (p = 0.0294). Analysis of invasion of a surgical margin demonstrated significant positivity in patients with papillary thyroid cancers who expressed VEGF-C (p = 0.0207) indicating the worse prognosis of a disease. Also a statistically significant correlation was between VEGF-C and extrathyroid extension, indicating the worse prognosis (p = 0.0133) in papillary cancers. The level of VEGF-C expression was statistically significant in patients with papillary thyroid cancer (p = 0.039).

Conclusions: This study undoubtedly demonstrates that VEGF-C expression is an evident negative prognostic factor in patients with papillary thyroid carcinoma, along with the classic prognostic factors, such as a larger tumor size, tumor margin involvement, extrathyroid extension, i.e. local aggressiveness.

Keywords: VEGF-C thyroid; angiogenesis; thyroid cancer.