VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF)

Cancer

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Angiogenesis marker.

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VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF) - Comprehensive Medical Test Guide

1. Why is it done?
- Test Description: The VEGF test measures the concentration of vascular endothelial growth factor, a protein that promotes the formation of new blood vessels (angiogenesis). This test detects VEGF levels in blood serum and is used to assess angiogenic activity in the body.
- Primary Indications: Cancer surveillance and monitoring (colorectal, gastric, breast, lung cancers); Evaluation of tumor progression; Assessment of response to anti-angiogenic therapy; Diagnosis of wet age-related macular degeneration (AMD); Evaluation of diabetic retinopathy; Investigation of angiogenic disorders; Monitoring of rheumatoid arthritis and inflammatory conditions
- Typical Timing: Baseline measurement before cancer treatment initiation; Regular intervals during cancer therapy (monthly to quarterly); At disease progression evaluation; During surveillance of angiogenic diseases; As part of comprehensive tumor assessment panels
2. Normal Range
- Reference Values: Normal serum VEGF levels typically range from 31 to 86 pg/mL (picograms per milliliter). Some laboratories report normal ranges as <100 pg/mL or <150 pg/mL depending on assay methodology. Reference values may vary between laboratories using different VEGF isoforms (VEGF-A is most commonly measured).
- Units of Measurement: pg/mL (picograms per milliliter) or pM (picomoles per liter)
- Result Interpretation: Low/Normal Values (31-86 pg/mL): Indicates normal angiogenic activity with appropriate blood vessel formation; Normal tissue perfusion and vascular function
- Elevated Values (>150-200 pg/mL): Suggests abnormal or pathological angiogenesis; Possible malignancy; Active inflammatory or ischemic processes; Impaired response to anti-angiogenic therapy
- Significantly Elevated Values (>300 pg/mL): High probability of malignancy; Advanced disease stage; Severe ischemic or inflammatory conditions; Poor prognostic indicator in cancer patients
3. Interpretation
- Clinical Significance of Results: Elevated VEGF levels correlate with increased angiogenesis and tumor burden in malignancies. Higher concentrations typically indicate more aggressive disease with greater metastatic potential. Serial measurements showing rising trends suggest disease progression or therapeutic failure.
- Cancer-Specific Interpretation: In colorectal cancer: Baseline VEGF >400 pg/mL associated with poor prognosis; Levels >150 pg/mL correlate with advanced disease. In gastric cancer: Elevated VEGF predicts shorter survival and increased recurrence. In breast cancer: High levels indicate increased angiogenesis and metastatic capability. In lung cancer: Prognostic marker for advanced disease stages.
- Response to Therapy: Decreasing VEGF levels during anti-angiogenic therapy (bevacizumab, sunitinib) indicate therapeutic response. Plateau or rising levels suggest treatment resistance. A decline >50% from baseline often predicts improved progression-free survival.
- Non-Malignant Conditions: Elevated in diabetic retinopathy and wet macular degeneration due to abnormal neovascularization. Increased in rheumatoid arthritis reflecting ongoing inflammation. Elevated in acute myocardial infarction during tissue repair phase. Raised in chronic inflammatory diseases.
- Factors Affecting Results: Platelet count (elevated platelets release VEGF); Sample processing and storage conditions; Time of blood collection; Assay methodology and laboratory variation; Acute stress or physical activity; Recent surgery or trauma; Medications (corticosteroids may decrease VEGF); Smoking status
4. Associated Organs
- Primary Organ Systems: Vascular system (endothelial cells throughout body); Tumor microenvironment in all cancer types; Eye (retina and choroid); Kidneys (glomerular filtration); Lungs (alveolar capillaries); Heart (coronary circulation); Brain (blood-brain barrier); Bone marrow (hematopoietic tissue)
- Associated Malignancies: Colorectal cancer; Gastric cancer; Breast cancer; Lung cancer (NSCLC and SCLC); Ovarian cancer; Prostate cancer; Lymphomas; Glioblastoma; Renal cell carcinoma; Hepatocellular carcinoma
- Associated Non-Malignant Diseases: Diabetic retinopathy; Age-related macular degeneration (wet form); Rheumatoid arthritis; Systemic lupus erythematosus; Rheumatoid vasculitis; Acute myocardial infarction; Peripheral arterial disease; Coronary artery disease; Ischemic stroke; Pneumonia and sepsis; Chronic kidney disease
- Potential Complications: Pathological angiogenesis leading to tumor vascularization and progression; Abnormal neovascularization in retina causing vision loss; Increased vascular permeability and edema; Enhanced metastatic potential; Hemorrhagic complications from fragile neovessels; Therapeutic resistance in cancer treatment; Ischemic complications from impaired vascular function
5. Follow-up Tests
- Additional Cancer Markers: Carcinoembryonic antigen (CEA) for colorectal cancer; CA 19-9 for gastric and pancreatic cancer; Cancer antigen 15-3 (CA 15-3) for breast cancer; Cancer antigen 125 (CA 125) for ovarian cancer; Prostate-specific antigen (PSA) for prostate cancer
- Angiogenic Marker Panel: Fibroblast growth factor (FGF); Platelet-derived growth factor (PDGF); Angiopoietin-1 and Angiopoietin-2; Placental growth factor (PlGF); Thrombospondin; Tissue inhibitors of metalloproteinases (TIMPs)
- Imaging Studies: CT or MRI scan for tumor assessment; PET-CT for disease staging; Ultrasound for tumor vascularity; Angiography to assess vessel formation; Optical coherence tomography (OCT) for retinal disease
- Monitoring Frequency: Monthly during active cancer therapy; Every 3 months during maintenance therapy; Every 6 months during surveillance; More frequently if clinical deterioration; Based on half-life (approximately 30 minutes for free VEGF)
- Complementary Investigations: Complete blood count (assess platelet contribution to VEGF); Liver and renal function tests; Coagulation studies; Inflammatory markers (CRP, ESR) for non-malignant conditions; Histopathology and immunohistochemistry of tumor tissue; Genetic testing for VEGF polymorphisms in research settings
6. Fasting Required?
- Fasting Requirement: No - Fasting is NOT required for VEGF testing. This test can be performed on both fasting and non-fasting blood samples.
- Sample Collection Requirements: Venous blood sample collected in standard collection tube (typically serum separator tube); Morning collection preferred for consistency; Gentle handling to avoid hemolysis; Plasma samples require anticoagulant (EDTA or citrate); Proper labeling and patient identification
- Sample Processing: Serum should be separated within 1-2 hours of collection; Store at 2-8°C if immediate processing not possible; Freeze at -20°C or -80°C for longer-term storage; Avoid repeated freeze-thaw cycles; Transport on ice to laboratory
- Medication Considerations: No medications need to be discontinued; Anti-angiogenic medications (bevacizumab, sunitinib, sorafenib) should be continued as prescribed; Note timing of last anti-cancer drug dose; Corticosteroids and NSAIDs may influence results but should be continued; Inform laboratory of all current medications
- Patient Preparation: No specific fasting required; Avoid strenuous exercise 24 hours before collection; Remain seated for 5-10 minutes before collection; Stay hydrated normally; Avoid smoking 30 minutes prior; Minimize stress and anxiety; Inform phlebotomist of any bleeding disorders; Wear comfortable loose-fitting clothing for easy blood draw access
- Turnaround Time: Results typically available within 3-7 business days; May be longer for specialized or reference laboratories; Contact laboratory for specific turnaround times; Rush processing may be available for additional fee

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