Serum Levels of Vascular Endothelial Growth Factor Dependent on the Stage Progression of Lung Cancer

In lung cancer, vascular endothelialgrowth factor (VEGF) is an important cytokine and is correlated withtumor vessel density, malignant pleural effusions, andcoagulation-fibrinolysis factors in vitro. Weinvestigated the correlation between serum VEGF level and stageprogression in lung cancer to study the predicted value of VEGF level. We also studied whether coagulation-fibrinolysis factors andPao2 levels, which are also important factorsfor the prediction of the clinical course, are correlated withVEGF. Forty-nine patients with lungcancer were investigated prospectively. VEGF levels of sera andmalignant effusions, and plasma concentrations of coagulation-fibrinolysis factors were measured by enzyme-linkedimmunosorbent assay. We measured Pao2 levels inall patients at rest. Serum levels of VEGFwere increased significantly according to stage progression. Additionally, plasma concentrations of D dimer, thrombin-antithrombincomplex (TAT), and tissue plasminogen activator/plasminogen activatorinhibitor type I complex were elevated significantly according to stageprogression. The serum VEGF level had a significant positivecorrelation with the TAT and D dimer levels. Serum VEGF levels had asignificant negative correlation with Pao2levels. The incidence of cerebral vascular disorder was significantlyhigher in the patients with systemic hypoxemia than in those without(p < 0.05). Mean VEGF levels in malignant effusions in eightpatients (five with pleural effusions, two with pericardial effusions, and one with both) were extremely high, especially in pericardialeffusions ([mean ± SD] pleural effusions, 531.9 ± 285.4 pg/mL;pericardial effusion, 3,071.6 ± 81.3 pg/mL). We predict that in lung cancer, VEGF productionand the abnormality of the coagulation-fibrinolysis system differdepending on the stage of progression of disease. Serum VEGF levelswould be affected by Pao2 levels in lungcancer.