VEGF-D and VEGF-C as Biomarkers in Endometrial Cancer: Association with Tumor Grade, Stage and Lymphovascular Invasion

Background. Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries. While clinicopathological factors such as tumour grade, The International Federation of Gynecology and Obstetrics (FIGO) stage, and lymphovascular invasion (LVI) are established prognostic indicators, reliable preoperative molecular biomarkers remain lacking. Vascular endothelial growth factors C and D (VEGF-C, VEGF-D) regulate lymphangiogenesis, but their circulating levels and prognostic relevance in EC have not been well characterized. Methods. Serum VEGF-C and VEGF-D concentrations were measured using ELISA in 100 patients with histologically confirmed EC. Associations with tumour grade, FIGO stage, and LVI were analyzed using Mann–Whitney U and Kruskal–Wallis tests. Results. Serum VEGF-D levels were significantly elevated in patients with high-grade tumours ( p  = 0.0172) and in those with confirmed LVI ( p  = 0.0244). The highest VEGF-D concentrations were observed in FIGO stage II, with lower levels in stage IV disease ( p  = 0.0205). No significant correlations were observed between VEGF-C levels and any clinicopathological parameters. Conclusions. Elevated VEGF-D levels are associated with unfavorable pathological features in EC, including poor differentiation and lymphovascular invasion, indicating its potential role as a non-invasive biomarker of tumour aggressiveness. Further prospective studies are needed to validate VEGF-D as a prognostic indicator in EC and to explore its clinical utility in risk stratification.