Populations studied and demographic characteristics
During the study, 1260 patients underwent gastric surgeries at TMH. Out of these, 268 were found to be positive for VEGF. Of these, 107 were excluded from the study because of failure to meet inclusion criteria. Thus, 161 patients were studied. Among the 161 gastric cancer patients, 101 (62.7%) gastric samples were regarded as strong VEGF-C expression group and 60 (37.3%) were regarded as weak VEGF-C expression group. (Figure 1). Patients’ ages ranged from 28 years to 81 years. The mean was 58 years, and the standard deviation was 10.44 years. The distribution between females and males was 29 females (18%) and 132 males (82%).
Figure 1. Flow chart diagram.
Table 1 below shows clinical characteristics associated with expression of
VEGF-C according to univariate analysis. There was no statistically significant association of VEGF-C expression in relation to age and sex. There was also no significant association between VEGF-C, smoking and alcohol intake (Table 1).
Table 1 Demographic characteristics correlated with expression of VEGF- C according to univariate analysis
Table 2 below shows Tumor characteristics associated with VEGF -C Expression on univariate analysis.
There was a statistically significant association of VEGF -C expression and Bormann classification. Tumors with strong VEGF-C expression were 4.86 more likely to be ulcerative type of gastric cancer than those presented with weak VEGF-C expression (OR:4.86,CI;1.10-7.11, P=0.013). There was a statistically significant association between strong VEGF-C expression and tumor grade (P=0.005). Strong VEGF-C expression were 4.88 more likely to be found in poorly differentiated gastric tumors than tumors with weak VEGF-C expression (OR=4.44,95% CI; 2.55-9.89). VEGF-C expression was also significantly associated with lymphatic involvement (P= 0.001). Malignancies with strong VEGF-C expression were 3.34 more likely to involve lymphatic system than those with weak VEGF- C expression (OR=3.34, 95% CI; 1.65 -7.20).
VEGF- C expression was negatively associated with TNM stage (P=0.005) . Gastric tumors with strong VEGF-C expression were less likely to develop advanced (TNM stage III- IV) gastric tumors than those with weak VEGF-C expression (OR=0.60,95% CI; 0.27- 0.94).
However, no statistically significant association was found between tumor location, tumor size, tumor stage, vascular involvement, histological classification and VEGF-C expression (Table 2).
Table 2. Tumor characteristics related to VEGF C expression on univariate analysis.
Multivariate logistic regression
Multivariate logistic regression analysis revealed that VEGF-C expression as a significant predictor for tumor grade (Adjusted odds ratio (AOR) 7.78, 95% confidence interval (CI); 2.78 to 9.29, P-value = 0.001), lymph node invasion (AOR 18.11;95% CI 4.32 to 22.81,P =0.013) and TNM staging (AOR 4.12,95% CI; 2.30 to 15.92; P = 0.005) in patient with gastric cancer (Table S1).
Table S1. Multivariate logistic regressions