Role of vascular endothelial growth factor C in classical Hodgkin lymphoma.

We performed three different studies to obtain additional data on the biological and prognostic role of vascular endothelial growth factor C (VEGFC) in classical Hodgkin lymphoma (cHL): (1) serum VEGFC levels were measured by enzyme-linked immunosorbent assay in 80 patients; (2) immunohistochemical VEGFC expression in tumor tissue was evaluated using a case-control study in 62 patients; (3) gene expression of VEGFC was investigated in vitro in six cHL cell lines, and was compared with expression in inflammatory lymph nodes. Higher serum VEGFC levels were found in patients with cHL than in healthy volunteers (median, 7675 vs. 1358 pg/mL, p < 0.001) and high VEGFC expression in tissue predicted worse progression-free survival at 7 years (41% vs. 91%, p < 0.0001). VEGFC expression in all Hodgkin lymphoma cell lines was higher than the mean expression level in inflammatory lymph nodes. Our data suggest that Hodgkin and Reed-Sternberg cells produce VEGFC, and VEGFC expression could be a novel prognostic factor in cHL.