AIM: To analyze the serum levels and prognostic significance of vascular endothelial growth factor (VEGF) -A,-C,and -D,and their receptors,VEGFR-1 and -2 in gastric adenocarcinomas.METHODS: The serum levels of VEGF family members were measured in 76 control subjects and 76 patients with gastric adenocarcinoma using an enzyme-linked immunosorbent assay (ELISA).These measurements were correlated with clinco-pathological features and survival rates.RESULTS: The serum levels of VEGF-A and its receptor,VEGFR-1,were significantly higher in patients with gastric cancer than in healthy donors (t = 2.3,P = 0.02 and t = 4.2,P＜0.0001,respectively).In contrast,the serum levels of VEGF-D were significantly higher in control subjects than in patients (t = 2.9,P = 0.004).There was no significant difference in serum levels of VEGF-C and VEGFR-2 between patients and controls.VEGF-C was associated with advanced tumor stage and presence of metastasis.VEGFR-1 was associated with metastasis,advanced overall stage,tumor differentiation and survival.VEGFR-2 levels were associated with poor tumor differentiation.There was no significant prognostic value for any of the VEGF family members or their receptors except for VEGFR-1 where high levels were associated with a poor overall survival.CONCLUSION: Serum VEGF levels vary significantly in the same cohort of patients with variable clinicopathological features and prognostic values.The simultaneous measurement of VFGF receptors levels in sera may overcome the limitations of a single biomarker assay.