In contrast, there was no statistically significant relationship between VEGF gene expression and the other factors.The IMD was significantly associated with the histopathological grading. of the G grade patients.With respect to the tumour status, the proportion of patients with hypervascular tumours increased from. of those patients with a T status.There was no statistically significant relationship between the IMD and the other factors.This difference was particularly evident in those patients with a M metastatic status. Furthermore, there was a medical significant difference in N nodal status. This difference was particularly evident in male and elderly patients. In addition, there were significant differences noted for the following variables: male, T tumour status, N or N nodal status, M metastatic Cozymase status and G or G histopathological grading. The IMD and VEGF status were found to be significant independent prognostic factors. The other variables PDECGF status, histopathological Dabigatran grading, tumour status, nodal status, metastatic status, gender, age at surgery were not significant.Of these factors, PDECGF and VEGF are particularly important angiogenic factors.PDECGF is an endothelial cell mitogen of relative molecular mass purified to homogeneity from human platelets, and has chemotactic activity for endothelial cells in vitro and angiogenic activity in vivo. In, PDECGF was identified as being homologous to thymidine phosphorylase, which catalyses the reversible phosphorylation of thymidine to thymine and deoxyribosephosphate; this enzymatic activity is crucial for the angiogenic activity.Takahashi et al have demonstrated that PDECGF was expressed in infiltrating cells in most of colon cancers, but rarely in tumour epithelium.Aberrant levels of VEGF have also been found in the sera from of the patients with earlystage breast cancer. However, the biologic significance of circulating endothelial growth factors is presently not known.VEGF expression increases in response to several stimuli such as hypoxia and the overexpression of transforming growth factor. In addition to tumour growth and metastasis, the endogenous upregulation of VEGF has been implicated as the basis for the angiogenesis associated with diabetic retinopathy. Our study also showed that the IMD was the most significant indicator of a poor prognosis among PDECGF expression, VEGF expression and the IMD.In colon cancers, PDECGF has been reported to be closely related to the IMD, and in gastric cancers VEGF was also correlated with the IMD. However, in pancreatic cancers, no significant relationship was found between PDECGF expression and the IMD; only VEGF expression was moderately correlated with the IMD. Indeed, PDECGF gene expression correlated with a poor prognosis in patients with pancreatic cancer, but these findings suggest that PDECGF may not play a more important role in angiogenesis than VEGF.However, tumours with both positive PDECGF and VEGF gene expression had a higher IMD than those with either negative or both negative expression. Furthermore, these patients with both positive PDECGF and VEGF gene expression had a significantly poorer prognosis than those with either negative or both negative expression. The activity of one factor may therefore facilitate the angiogenic activity of the other factor.For example, the chemotactic activity of PDECGF might facilitate tubule formation after the proliferation of the endothelial cells secondary to VEGF activity.