Gallbladder cancer (GBC) is a highly fatal disease with poor prognosis and few therapeutic alternatives. Molecular mechanisms involved in GBC pathogenesis remain poorly understood. The Vascular Endothelial Growth Factor A (VEGF) is a potent proangiogenic agent involved in the carcinogenesis of many human tumors and it is an attractive target for cancer therapy. The aim of this study was characterize VEGF expression in advanced gallbladder cancer and determine it's relationships with clinicopathologic features and utility as a prognostic factor. VEGF expression was examined by immunohistochemistry (IHC) in tissue microarrays containing 224 advanced gallbladder carcinomas and 39 cases of chronic cholecystitis (CC). The advanced GBC were classified as low or high expression to evaluate the association of VEGF expression level with clinical variables. Statistical analysis was performed using univariate analyses with a significance level of P<0.05; survival analysis was performed by the Kaplan- Meier method with the log-rank test. High expression of VEGF was observed in 183 of 224 (81%) tumors and 2 of 39 (5.1%) of chronic cholecystitis (P<0.0001). The VEGF expression had a significant relationship with clinical or pathological features included histological grade and TNM stage (P<0.05). Moreover, 5-year survival analysis indicated that high expression of VEGF is associated with a poor prognosis in patients with advanced gallbladder cancer (P = 0.0116). Our results indicate that VEGF is highly expressed in gallbladder cancer and correlates with poor prognostic, suggesting that VEGF expression could be used as a biomarker for predicting malignant behavior and to identify a subset of patients who may benefit from anti-VEGF therapies.

Citation Format: Pablo Letelier, Kurt Buchegger, Carmen Ili, Patricia Garcia, Priscilla Brevi, Alejandra Sandoval, Pamela Leal, Ismael Riquelme, Juan Carlos Roa. Expression of vascular endothelial growth factor a (VEGF-A) in advanced gallbladder cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3907. doi:10.1158/1538-7445.AM2013-3907