Vascular endothelial growth factor expression in oligodendrogliomas: a correlative study with Sainte-Anne malignancy grade, growth fraction and patient survival

Neuropathol Appl Neurobiol. 2000 Aug;26(4):379-89. doi: 10.1046/j.1365-2990.2000.00263.x.


Microangiogenesis is a delayed but crucial event in the malignant progression of oligodendrogliomas. Accord-ingly, in the new Sainte-Anne grading system of oligodendrogliomas, endothelial hyperplasia and contrast enhancement, both being indicators of microangiogenesis, are key criteria for the distinction of grade A from grade B tumours. Vascular endothelial growth factor (VEGF) is a potent angiogenic factor: a strong correlation between VEGF expression, Sainte-Anne malignancy grade and patient outcome might thus be expected. In order to assess this hypothesis, VEGF immunostaining was performed in a series of 34 oligodendrogliomas that included 11 grade B and 23 grade A, of which nine became grade B during the study period (mean clinical and imaging follow-up: 41 months). VEGF expression correlated strongly with Sainte-Anne tumour grade (P < 0.001), and inversely with patient survival (P < 0.001) and recurrence-free survival (P = 0.002). One hundred per cent of grade B but only 17% of grade A were VEGF-positive. By contrast, the MIB-1 labelling index did not correlate with VEGF expression, total survival or recurrence-free survival. In accordance with the grading system, this study showed that, in oligodendrogliomas, VEGF expression and microangiogenesis are progression-related phenomena that confer on these tumours a growth advantage by presumably reducing hypoxia-induced apoptotic cell death. These findings might have important implications in the future for the indication and timing of anti-angiogenic therapies.

MeSH terms

  • Adult
  • Aged
  • Antigens, Nuclear
  • Brain Neoplasms / metabolism*
  • Brain Neoplasms / mortality*
  • Brain Neoplasms / pathology
  • Cell Division
  • Disease-Free Survival
  • Endothelial Growth Factors / biosynthesis*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen
  • Lymphokines / biosynthesis*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local
  • Nuclear Proteins
  • Oligodendroglioma / metabolism*
  • Oligodendroglioma / mortality*
  • Oligodendroglioma / pathology
  • Proportional Hazards Models
  • Statistics as Topic
  • Survival Rate
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factors


  • Antigens, Nuclear
  • Endothelial Growth Factors
  • Ki-67 Antigen
  • Lymphokines
  • Nuclear Proteins
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factors