Correlation of VEGF and HIF-1α in breast carcinoma (an immunohistochemical study)

Introduction: By 2030 the incidence of breast cancer in India will increase to around 200,000 per year. During tumor growth, angiogenesis is induced by many stimuli. Reduced oxygen stimulates hypoxia induced factor 1 alpha (HIF-1α), activating proangiogenic cytokines i.e. vascular endothelial growth factor (VEGF). The best-studied factor is VEGF-A. Overexpression of HIF promotes metastasis of cancers. Higher the levels of VEGF, poorer the prognosis. HIF-1α is an independent prognostic factor for an unfavorable prognosis. Materials and Methods: Study was conducted on 50 cases of breast cancer specimens. Histopathological typing and grading was done followed by immunohistochemistry for HIF-1α expression. Serum samples were collected for VEGF levels. Observations and Results: Most patients were in the age group of 41-60 years. 94% of the tumors were infiltrating ductal carcinoma NOS the remaining being mucinous (4%) and tubular (2%). 16 cases were Grade II and 34 cases were Grade III. Lymph nodes were recovered in 44 cases of radical mastectomy. Metastatic carcinomatous deposits were present in 26 cases. Lynphovascular invasion (LVI) was seen in 20 cases. sVEGF levels were increased in 21 cases. No correlation was seen with grade of tumor whereas a positive correlation was seen with LVI and lymph node status. No positive correlation was seen with HIF-1α and all these parameters. No significant correlation was seen between sVEGF levels and HIF-1α. Conclusion: sVEGF levels have direct relationship with LVI and lymph node status and should be taken as a poor prognostic factor. HIF-1α was increased more in high grade tumors but had no statistical significance with LVI and lymph node status.