Clinical significance of vasculogenic mimicry in human gliomas

J Neurooncol. 2011 Nov;105(2):173-9. doi: 10.1007/s11060-011-0578-5. Epub 2011 Apr 30.

Abstract

Vasculogenic mimicry (VM) is known as non-endothelial tumor cell-lined microvascular channels in aggressive tumors. We have previously found the presence of VM in high-grade gliomas. In this study, we aimed to identify VM patterns in gliomas and to explore their clinical significance. Tumor samples as well as their detailed clinical/prognostic data were collected from 101 patients. Vasculogenic mimicry in the glioma samples was determined by dual staining for endothelial marker CD34 and periodic acid-Schiff (PAS). Tumor samples were also immunohistochemically stained for Ki-67, VEGF, COX-2 and MMP-9. The association between VM and the clinical characteristics of the patients were analyzed. A Kaplan-Meier survival analysis and log-rank tests were performed to compare survival times of the patients. Vasculogenic mimicry was present in 13 out of 101 samples. The higher grade gliomas had a higher incidence of VM than that of lower grade gliomas (P = 0.006). Vasculogenic mimicry channels were associated with the expression of COX-2 and MMP-9 (P < 0.05). While there was no association between the existence of VM and the sex, age and preoperative epilepsy of the patients, or expression of Ki-67 and VEGF. However, patients with VM-positive gliomas survived a shorter period of time than those with VM negative gliomas (P = 0.027). Interestingly, in high-grade gliomas, the level of microvascular density was lower in VM positive tumors than those VM negative tumors (P = 0.039). Our results suggest that VM channels in gliomas correlate with increasing malignancy and higher aggressiveness, and may provide a complementation to the tumor's blood supply, especially in less vascularized regions, which may aid in the identification of glioma patients with a poorer prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Neoplasms / blood supply*
  • Brain Neoplasms / mortality
  • Brain Neoplasms / pathology*
  • Child
  • Child, Preschool
  • Cyclooxygenase 2 / metabolism
  • Female
  • Follow-Up Studies
  • Glioma / blood supply*
  • Glioma / mortality
  • Glioma / pathology*
  • Humans
  • Immunoenzyme Techniques
  • Ki-67 Antigen / metabolism
  • Male
  • Matrix Metalloproteinase 9 / metabolism
  • Middle Aged
  • Neoplasm Grading
  • Neovascularization, Pathologic / metabolism
  • Neovascularization, Pathologic / pathology*
  • Prognosis
  • Survival Rate
  • Vascular Endothelial Growth Factor A / metabolism
  • Young Adult

Substances

  • Ki-67 Antigen
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Cyclooxygenase 2
  • PTGS2 protein, human
  • Matrix Metalloproteinase 9