PROGNOSTIC VALUE OF VEGF EXPRESSION IN TISSUES OF SEROUS ADENOCARCINOMA OF FALLOPIAN TUBES

In spite of significant progress in the study of malignant neoplasms, primary cancer of the fallopian tubes remains an understudied disease. There is increasing evidence of serous fallopian tube, ovary, peritoneum and mammary gland cancer with gene mutations. In practical oncogynecology, an analysis of immunohistochemical markers is of great importance, which provides important information about tumor tissue and allows determining the prognosis of the disease. The aim of the research was to study the features of VEGF expression in the tissue of the serous adenocarcinoma of the fallopian tubes (SAFT) and compare the results to the receptor hormonal status, proliferative potential, and markers of apoptosis in the tumor. Till now no complete picture of the role of VEGF expression in tumor cells in patients with serous adenocarcinoma of fallopian tubes has been received, the clarification of such relationships will be important both for assessing the prognosis of the disease and for planning the tactics of individual treatment. Methods. Morphological and immunohistochemical reserches were performed on the surgical material received from 66 patients with SAFT operated in specialized medical institutions. For the determination of autogenic stimulation of angiogenesis, the expression of VEGF receptors using polyclonal rabbit antibodies and its relationship with the markers of proliferation (Ki-67, clone SP6), apoptosis (p53, clone SP5 and bcl-2, clone 100/D5) and hormonal status tumor (ER, clone SP1 and PR, clone YR85) was studied. Research results. Most patients with SAFT (87.9%) had moderate or severe cytoplasmic reactions in endothelial cells and more than 70% of tumor cells located diffusively in the field of vision. Tumors with weak and moderate focal expression of 10-50% of neoplastic cells, which also had negative stained zones, accounted for 6 (9.1%) cases. Focal weak cytoplasmic reaction that was present in less than 10% of tumor cells and in the endothelium of single vessels was observed in 2 cases (3%). We determined that the angiogenic potential of malignant tumors of FT depended on the degree of differentiation of neoplasia (r=0.24, p<0.05) and the clinical stage of the disease (r=0.21, p<0.05). All cases of metastasis in regional lymph nodes were accompanied by high expression of VEGF receptors. There was a negative correlation with the level of expression of ER (r=-0.25, p<0.05) and PR (r=-0.22, p<0.05). There is a weak correlation between the expression of VEGF and p53 (r=0.25, p<0.05). There was no statistically significant relationship between expression of VEGF receptors and the presence of receptors for Ki-67 and bcl-2 (p>0.05). Conclusions. The VEGF expression can be used with high probability as prognostic markers that determine the rate of growth of the tumor and the risk of metastasis. In addition, the high angiogenic potential of neoplasia will allow the use of anti-VEGF therapy, which will increase the effectiveness of treatment and improve the overall recovering of patients.