Plasma Vascular Endothelial Growth Factors A and C inPatients undergoing Prostatic Biopsy and TURP for SuspectedProstatic Neoplasia

Background: Formation of new blood vessels is necessary for the development and spread of neoplasms morethan 1 mm3 in volume, angiogenesis being responsible for formation of new from pre-existing blood vessels.Vascular endothelial growth factor (VEGF) is pivotal and the best studied angiogenic factor in all humancancers. Therefore we designed this study to investigate the role of VEGF-A and VEGF-C in prostate cancer incomparison with BPH controls in a north Indian population.
Methods: In this case-control study a total of 100subjects were included on the basis of confirmed histopathological reports, out of which 50 were prostate cancerpatients and the other 50 were BPH patients with PSA levels >2 ng/ml and abnormal digital rectal examination(DRE) findings during September 2009 to August 2011 from the Department of Urology, KGMU, Lucknow, India.Plasma levels of VEGF were determined using quantitative immunoassay (ELISA- enzyme linked immunosorbentassay). Statistical analysis was carried out using SPSS 15.0 version.
Results: The mean age of prostate cancer(67.6±5.72) patients was significantly higher (p=0.005) than BPH (63.6±7.92) patients. Expression of VEGF-Awas not significantly higher in disease stage C1 than D1 or D2 and A or B (p=0.13) while the level of VEGF-Awas significantly higher (p=0.04) in prostate cancer as compared to BPH subjects (PCa=13.0 pg/ml, BPH=6.8pg/ml). Levels of VEGF-C were similar in both groups (PCa=832.6 pg/ml, BPH=823.7 pg/ml). In ROC curve,the area under curve (AUC) was 0.70 (95%CI: 0.60-0.80) and the cut-off value for which a higher proportion ofpatients was correctly classified (20%) was 26.0 pg/mL.
Conclusion: Although VEGF-A is increased in cancerprostate patients a statistically significant correlation could not be established in this study. VEGF-C was notfound to be a useful biomarker.