Expressional evaluation of vascular endothelial growth factor (VEGF) protein in urinary bladder carcinoma patients exposed to cigarette smoke.

Angiogenesis is a fundamental process in tumor growth and metastasis. Expression of vascular endothelial growth factor (VEGF) as prognostic indicator has been documented in many types of human tumors. However, the mechanisms responsible for angiogenesis in urinary bladder carcinoma patients are not well defined. Certain carcinogens in tobacco cause DNA damage and may produce specific mutations. In order to investigate the relationship between tobacco smoking, altered patterns of VEGF expression and apoptosis, we have analyzed a group of 125 incident patients with transitional cell carcinoma and 100 cases of control with inflammatory lesions of the bladder. We assessed VEGF overexpression by the use of anti- VEGF antibody through immunohistochemistry, and apoptosis by TUNEL Assay. Expression of VEGF and apoptosis was noticed in 43.2% and 52.8% cases respectively. Both VEGF and apoptosis increased with increasing tumor grade. Apoptosis was seen to be significantly higher in both sexes in the age group of ≥ 50 years (p<0.05) but expression of VEGF was significantly higher among males in the age group of ≥ 50 years (p<0.05). We observed an insignificant association between cigarettes smoking and VEGF overexpression (p>0.05) and significant association with apoptosis. These data support the hypothesis that certain carcinogens derived from cigarette smoking may induce VEGF mutations and apoptosis which in turn are involved in early steps of bladder carcinogenesis.