Serum vascular endothelial growth factor-C level in patients with primary nonsmall cell lung carcinoma: a possible diagnostic tool for lymph node metastasis.

BACKGROUND: The authors measured circulating vascular endothelial growth factor-C (VEGF-C) and vascular endothelial growth factor (VEGF) levels in patients with primary nonsmall cell lung carcinoma and assessed its usefulness as a diagnostic tool for determining lymph node metastasis.

METHODS: Ninety-two patients with nonsmall cell lung carcinoma and 58 patients with benign tumors of the lung were included in the current study, as well as 42 healthy control patients. Circulating VEGF-C and VEGF levels were assessed by enzyme-linked immunosorbent assay.

RESULTS: Serum VEGF-C concentration was higher in patients with lung carcinoma than in patients with benign tumors or in healthy control patients. Patients with lymph node metastasis revealed higher serum VEGF-C and VEGF concentrations than those without. The median level of VEGF-C and VEGF according to lymphatic vessel invasion and venous invasion was higher in the group with invasion than in the group without. These differences were most significant among patients with VEGF-C with lymphatic vessel invasion (P = 0.0066 vs. P = 0.026) and in patients with VEGF with venous invasion (P = 0.19 vs. P = 0.011). Serum VEGF-C levels reached a sensitivity of 79% and a specificity of 72% with a cutoff value of 1756.0 pg/mL, whereas VEGF levels reached 68% sensitivity and 70% specificity at 327.8 pg/mL. If 92 patients were divided into 4 groups according to the combination of VEGF-C and VEGF levels, the positive predictive value was 84.2%, the negative predictive value was 95.8%, and accuracy was 93.1%.

CONCLUSIONS: Circulating VEGF-C levels may provide additional information for distinguishing between the absence and presence of lymph node metastasis in patients with lung carcinoma.