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Pro and Anti-Angiogenic Vascular Endothelial Growth Factors Expression in Benign and Malignant Thyroid Lesions

Eduardo Anselmo Garcia, Kleber Sim?es, Alda Wakamatsu, Cinthya dos Santos Cirqueira, Ven?ncio Avancini Ferreira Alves, Adhemar Longatto-Filho, PMIAC, Roberto Souza Camargo

Vascular endothelial growth factors are the most powerful molecules related to angiogenesis and lymph angiogenesis stimulation and are frequently associated to a worse prognosis in many malignancies. Currently, anti-angiogenic VEGF-A165b has been described and it have been demonstrated to efficiently block the angiogenic sprout. We sought to investigate the VEGF family members expression involved with angiogenesis (including the anti-angiogenic VEGF-A165b) and lymph angiogenesis. The casuistic was composed by 196 cases. The frequencies of thyroid lesions were: 53 (27%) goitres, 16 (8%) thyroiditis, 9 (5%) follicular adenomas, 84 (43%) papillary carcinomas, and 34 (17%) follicular carcinomas. The immunohistochemical reactions for VEGF-A, VEGF-A165b, VEGF-B, VEGF-C and VEGF-D were performed and semi-quantitatively assessed. We observed a widespread positive immunoexpression of VEGF-A and VEGF-A165b in benign and malignant lesions. None of the benign samples of this casuistic had positive immunoexpression of VEGF-B and only a few positive cases were detected in both papillary and follicular carcinomas. The highest levels of VEGF-C and VEGF-D expression were found in papillary carcinomas. There was a relevant association of VEGF-D and a worst tumoral staging (p=0.004) in papillary carcinomas. We also identified a significant association between VEGF-A and vascular invasion (p=0.049) and patient’s age and an increased expression of VEGF-B (p=0.047) in papillary thyroid carcinomas. No association was found for follicular carcinomas.