Clinical significance of serum vascular endothelial growth factor in malignant pleural mesothelioma

Our plain-English summary of Clinical significance of serum vascular endothelial growth factor in malignant pleural mesothelioma, by A. Yasumitsu, C. Tabata, R. Tabata, et al (Journal of Thoracic Oncology, 2010).

The study

• Authors: A. Yasumitsu, C. Tabata, R. Tabata, N. Hirayama, A. Murakami, S. Yamada, T. Terada, S. Iida, K. Tamura, K. Fukuoka, K. Kuribayashi, T. Nakano
• Journal: Journal of Thoracic Oncology
• Published: 2010;5(4):479-83
• Cited by: 63 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Introduction: Malignant pleural mesothelioma (MPM) is an aggressive malignant tumor of mesothelial origin associated with asbestos exposure. MPM has a limited response to conventional chemotherapy and radiotherapy so diagnosing MPM early is very important. Vascular endothelial growth factor (VEGF) is an autocrine growth factor for MPM. Here, we investigated the serum levels of VEGF in patients with MPM in comparison with a population that had been exposed to asbestos without developing MPM.

Methods: Serum concentrations of VEGF were measured in 51 patients with MPM and 42 individuals with benign asbestos-related diseases (asbestosis or pleural plaques) or who were healthy despite asbestos exposure.

Results: We demonstrated that patients with MPM had significantly higher serum levels of VEGF than a population who had been exposed to asbestos but had not developed MPM, and the patients with advanced stage MPM showed higher levels of VEGF than the early stage patients with MPM. The difference in overall survival between the groups with VEGF serum levels lower and higher than the assumed cutoff of 460 pg/ml was significant.

Conclusions: Our data suggest that the VEGF serum concentration could be a useful marker for screening MPM among asbestos-exposed individuals and as a prognostic factor.

In plain English

This study at Hyogo College of Medicine Hospital in Japan measured a blood protein, vascular endothelial growth factor (VEGF), in serum collected from 2000 to 2007 from 93 people with a documented history of asbestos exposure. Fifty-one had malignant pleural mesothelioma (MPM), 29 had pleural plaques and/or asbestosis, and 13 had no asbestos-related lesions. Average serum VEGF was 965.1 pg/ml in the mesothelioma patients and 242.3 pg/ml in the 42 people without mesothelioma, a statistically significant difference. At a cutoff of 460 pg/ml, the test identified 70.6% of the mesothelioma patients (sensitivity) and correctly excluded 88.1% of those without it (specificity). Levels showed a statistically significant tendency to rise with disease stage. Among 44 mesothelioma patients followed for up to 1300 days, overall survival differed significantly between the 12 patients below the cutoff and the 32 above it. However, a multivariate analysis that also took account of age, sex, histology, stage, performance status and treatment found no statistically significant prognostic effect. The authors concluded that serum VEGF could be a useful marker for screening for MPM among asbestos-exposed people and as a prognostic factor.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Hospital-based blood marker (biomarker) study comparing serum VEGF levels between patients with mesothelioma and asbestos-exposed people without it, with survival analysis in the mesothelioma patients
• Who was studied: 93 asbestos-exposed individuals seen at the Department of Respiratory Medicine, Hyogo College of Medicine Hospital, Japan, 2000 to 2007. Of these, 51 had malignant pleural mesothelioma, 29 had pleural plaque and/or asbestosis, and 13 had no asbestos-related lesions.
• Exposure: Documented history of asbestos exposure in all participants. Fiber types, jobs and doses were not reported.
• Main results:
  • Mean serum VEGF was significantly higher in patients with MPM (965.1 pg/ml) than in the 42 asbestos-exposed people with benign asbestos-related disease or no disease (242.3 pg/ml)
  • Distinguishing MPM patients from non-MPM asbestos-exposed subjects: area under the ROC curve 0.8623 (95% confidence interval, 0.8001 to 0.9245). At the 460 pg/ml cutoff, sensitivity was 70.6% and specificity was 88.1%.
  • In MPM patients, serum VEGF showed a statistically significant tendency to increase with stage. Mean values: stage I 523.3, stage II 409.6, stage III 1128.8 and stage IV 1142.8 pg/ml.
  • Differences in serum VEGF between MPM histologic types (epithelioid, sarcomatoid, biphasic, desmoplastic) and between the sexes were not statistically significant
  • There were no significant differences in VEGF levels between subjects with benign asbestos-related diseases and those who were healthy despite asbestos exposure
  • Of 51 MPM patients, 44 were followed for up to 1300 days. Overall survival differed significantly between the 12 patients below the 460 pg/ml cutoff and the 32 patients above it.
  • In Cox regression on 44 MPM patients, with data on age, sex, histology, stage, performance status and treatments, a statistically significant prognostic effect was not found
  • The authors also measured serum VEGF in 10 patients with lung cancer with pleuritis and found lower levels (548.5 pg/ml) than in patients with MPM. In 5 healthy volunteers never exposed to asbestos, the level was 230.2 pg/ml.
• The authors' conclusion: The authors concluded that serum VEGF concentration could be a useful marker for screening for MPM among asbestos-exposed individuals and as a prognostic factor

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Asbestos Exposure, Chemotherapy, Pleural Plaques, Overall Survival.

Related studies

• Clinical significance of serum vascular endothelial growth factor in malignant pleural mesothelioma — N. Fujimoto, K. Gemba, et al. (2011)
• Vascular endothelial growth factor in pleural fluid for differential diagnosis of benign and malignant origin and its clinical applications — A. Fiorelli, G. Vicidomini, et al. (2011)
• Pleural effusion VEGF levels as a prognostic factor of malignant pleural mesothelioma — N. Hirayama, C. Tabata, et al. (2011)
• Vascular endothelial growth factor is an autocrine growth factor in human malignant mesothelioma — L. Strizzi, A. Catalano, et al. (2001)
• Novel orthotopic implantation model of human malignant pleural mesothelioma (EHMES-10 cells) highly expressing vascular endothelial growth factor and its receptor — E. Nakataki, S. Yano, et al. (2006)
• The presence of simian-virus 40 sequences in mesothelioma and mesothelial cells is associated with high levels of vascular endothelial growth factor — P. Cacciotti, L. Strizzi, et al. (2002)

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