Association Between Color Doppler Vascularity Index, Angiogenesis-Related Molecules, and Clinical Outcomes in Gastric Cancer

Purpose: This Study was conducted to evaluate the correlation between color Doppler vascularity index (CDVI), clinical outcomes and five angiogenesis-related Molecules including vascular endothelial growth factor (VEGF), placenta growth factor (PIGF), cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), and calreticulin (CRT) in gastric cancer, and to develop an effective model selected from these five molecules to predict patient survival. Patients and Methods: CDVI could be obtained preoperatively by transabdominal ultrasound from 30 patients. Enzyme immunoassay was adopted to determine protein level of VEGF and PIGF and immunohistochemistry was used to detect COX-2. iNOS and CRT expression. Correlation between CDVI and five individual molecules was assessed. Multiple molecules model was developed using classification and regression tree (CART) analysis from five molecules, and was tested for patient survival in another 45 patients. Results: CDVI was significantly correlated with patient survival (P = 0.00907) and absolute number of metastatic lymph nodes (P = 0.01). There was no significant association between CDVI and any individual molecule. The model, developed by CART consisting of VEGF and PIGF Could differentiate high and low CDVI and survival in testing (P = 0.00257). Conclusions: CDVI was associated with lymph node metastasis, combined VEGF and PIGF expression status and patient Survival in gastric cancer. J. Surg. Oncol. 2009;99:402-408. (C) 2009 Wiley-Liss, Inc.