Angiogenesis Versus Antiangiogenesis in Colorectal Cancer Patients with and Without Liver Metastases

Document Type : Original Article

Authors

1 Department of Medical Biochemistr, Faculty of Medicine , Cairo University.

2 Department of Surgery ,Faculty of Medicine , Cairo University.

3 Department of Internal Medicine, Faculty of Medicine, Cairo University.

4 Department of Radiology, National Cancer Institute, Cairo University.

Abstract

Angiogenesis is essential for tumor growth and progression and is mediated by
positive and negative regulators of vessel growth. Since angiogenic mediators found
in patient's serum have been postulated to reflect the angiogenic potential of a
malignant tumor, the angiogenic stimulators activity such as vascular endothelial
growth factor (VEGF) and angiogenesis inhibitors such as endostatin have been
evaluated in the serum of patients with colorectal caner (CRC) with and without liver
metastases, in an attempt to study the prognostic value of the above parameters. The
present work was conducted on thirty six patients with colorectal cancer and twelve
control subjects. The patients' group included twenty localized colorectal cancer
patients all of them had radical surgical resection. The second patients' group
consisted of sixteen colorectal cancer patients with liver metastases. The serum
endostatin and VEGF levels weresignificantly higher in the patients with colorectal
cancer versus healthy controls. When compared according to tumor stage, the liver
metastatic group had significantly higher levels of serum endostatin and VEGF
versus the localized invasive group (without distant metastasis). Both groups
of patients with localized invasive cancer and patients with liver metastasis had
significantly higher mean serum endostatin and VEGF levels versus healthy controls.
Serum endostatin and VEGF levels inlocalized invasive group decreased
significantly after resection of the tumor. There was a significant positive correlation
between preoperativeendostatin and VEGF levels inall cancer patients. High
preoperative VEGF and endostatin levels were strongly associated with the tumor
size, tumor grade, lymph node metastases and subsequent recurrence. Significant
positive correlation was, also, detected between endostatin levels and number as well
as volume of hepatic metastases.The previous results denote that serum levels of
endostatin, and VEGF were elevated and positively correlated in patients with CRC.
The elevation was associated with the stage of CRC, greater disease burden and
subsequent recurrence. Thus, elevation ofserum levels of endostatin, and VEGF
might be considered as indicators of tumor invasion and metastasis in the future.
Thus, the present study demonstrates the prognostic utility of measuring angiogenic
and antiangiogenic factors before resection of colorectal cancer.

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