Serum vascular endothelial growth factor in patients with nonmelanoma primary ocular malignancies: A possible potential biomarker of tumor progression and poor prognosis.

CONTEXT: Vascular endothelial growth factor (VEGF) is a potent and specific angiogenic growth factor that may participate in the formation of the vascular tumor stroma. Pretreatment VEGF levels can be a biomarker to predict tumor progression and prognosis in patients with primary ocular malignancies. AIMS: The aim of this study was to estimate the serum vascular endothelial growth factor (VEGF) in various ocular malignancies, correlate with clinicpathological parameters, and assess its prognostic and therapeutic implications. SETTINGS AND DESIGN: This hospital-based observational study includes a total of 32 newly diagnosed histopathologically confirmed, patients with ocular malignancy. SUBJECTS AND METHODS: Circulating VEGF levels were measured using as and which enzyme-linked immunosorbent assay technique in 32 patients and 16 healthy controls. Serum VEGF levels were expressed as means ± standard deviation and compared using a one-way analysis of variance test, Chi-squared test, and Student's t-test were used. RESULTS: Mean serum VEGF levels were significantly raised in patients as compared to healthy controls (79.85 ± 22.16 vs 67.15 ± 6.84 pg/ml). Moreover, VEGF levels were maximum in retinoblastoma (111.86 ± 33.54 pg/ml), followed by sebaceous gland carcinoma (77.83 ± 11.37 pg/ml), ocular surface squamous neoplasia (70.57 ± 5.84 pg/ml), and basal cell carcinoma (67.96 ± 4.55 pg/ml). No significant change in serum VEGF level depending on histopathological differentiation (P = 0.151). Overall, VEGF levels were markedly elevated in the advanced stage as compared to those with the early stage (94.43 ± 26.71 vs. 68.51 ± 6.20 pg/ml). Significant increase in VEGF levels was also found in patients with lymph node metastasis (108.90 ± 27.31 pg/ml, P < 0.001) and distant metastasis (124.71 ± 28.27 pg/ml, P < 0.001). In addition, recurrence was observed in 18.75% of patients with high-level VEGF (104.69 ± 35.78 pg/ml). CONCLUSIONS: Serum VEGF may be a useful biomarker to assess disease severity, predict prognosis, and assess the likelihood of recurrence in various ocular cancers.