

The phenotype of vasculature within lung tumors has been shown to vary based on both location within the tumor and level of vascular endothelial growth factor (VEGF) expression. Specifically, research by Ushijima et al in a retrospective analysis of samples from 255 stage I–III non-small cell lung cancer (NSCLC) patients showed a relationship between peripheral microvessel counts and poor prognosis, but did not find the same correlation with central microvessel counts. Patient survival was poorer when these peripheral vessels were associated with high levels of VEGF.11 Similarly, Koukourakis and colleagues found that elevated microvessel counts localized on the advancing fronts of NSCLC tumors were also correlated with poorer outcomes.10,12