Gil-Bazo Ignasio, Catalán Goni Victoria, Alonso Gutiérrez Alvaro, Rodríguez Rodríguez Javier, Páramo Fernández José Antonio, de la Cámara Gómez Juan, Hernández Lizoain José Luis, García-Foncillas López Jesús
Departamento de Oncología, Clínica Universitaria, Universidad de Navarra, Pamploma, Spain.
Clin Transl Oncol. 2005 May;7(4):150-5. doi: 10.1007/BF02708752.
von Willebrand factor (vWf) is thought to mediate binding of tumour cells to platelets and to favour their systemic spreading capacity. Platelets involved in tumour angiogenesis are capable of releasing vascular endothelial growth factor (VEGF). Hence, levels of vWf and VEGF may correlate with cancer stage. The objectives are determine the impact of surgery and chemotherapy on vWf and VEGF in colorectal cancer (CRC) patients.
Twenty healthy volunteers (group 1), 14 patients with locally advanced CRC (group 2) and 12 patients with metastatic CRC (group 3) were enrolled. Blood samples were taken at recruitment in group 1, and before and after surgery and chemotherapy in groups 2 and 3, respectively. Blood levels of vWf, VEGF, platelet count, C-reactive protein (CRP), ceruloplasmin and carcinoembrionary antigen (CEA) were measured.
At baseline, group 3 showed higher concentrations of vWf than the other groups (p<0.05). In group 2, vWf became elevated 40% post-surgery (p=0.016), independently of changes in CRP or ceruloplasmin. In group 3, chemotherapy caused a 42% reduction in VEGF (p=0.015).
There was a strong correlation between higher vWf levels and more advanced CRC stage at diagnosis. These levels were elevated post-surgery in patients with locally advanced CRC. Chemotherapy significantly decreased VEGF in metastatic CRC patients before CEA showed any significant change.
血管性血友病因子（vWf）被认为可介导肿瘤细胞与血小板的结合，并有利于肿瘤细胞的全身扩散能力。参与肿瘤血管生成的血小板能够释放血管内皮生长因子（VEGF）。因此，vWf和VEGF的水平可能与癌症分期相关。本研究的目的是确定手术和化疗对结直肠癌（CRC）患者vWf和VEGF的影响。
招募了20名健康志愿者（第1组）、14名局部晚期CRC患者（第2组）和12名转移性CRC患者（第3组）。第1组在招募时采集血样，第2组和第3组分别在手术和化疗前后采集血样。检测血中vWf、VEGF、血小板计数、C反应蛋白（CRP）、铜蓝蛋白和癌胚抗原（CEA）的水平。
在基线时，第3组的vWf浓度高于其他组（p<0.05）。在第2组中，术后vWf升高了40%（p=0.016），与CRP或铜蓝蛋白的变化无关。在第3组中，化疗使VEGF降低了42%（p=0.015）。
诊断时vWf水平较高与更晚期的CRC分期之间存在密切相关性。局部晚期CRC患者术后这些水平升高。在转移性CRC患者中，化疗在CEA出现任何显著变化之前就显著降低了VEGF。
