Zafirellis Kyriakos, Agrogiannis George, Zachaki Aglaia, Gravani Katerina, Karameris Andreas, Kombouras Christos
Department of Surgery, Karditsa General Hospital, Karditsa, Greece.
J Surg Res. 2008 Jun 1;147(1):99-107. doi: 10.1016/j.jss.2007.05.041. Epub 2007 Jul 26.
The prognostic value of vascular endothelial growth factor (VEGF) expression in colorectal cancer is still unclear, as shown by the discordant results still reported in the literature. The aim of the study was to examine the expression of VEGF in colorectal adenocarcinomas and investigate its prognostic relevance.
VEGF expression was investigated by immunohistochemistry performed on tissue microarrays, in a series of 117 colorectal cancer specimens. The VEGF staining intensity in the cytoplasm of tumor cells was quantified using a semi-automated computerized image analysis and correlated with various clinicopathological characteristics and survival.
All tumors evaluated showed expression of VEGF, which were further divided into 49 high expression and 68 low expression tumors by their staining intensity. In tumors with lymph node metastasis, the intensity of staining of VEGF was more intense than in those without (P < 0.0001). Furthermore, the intensity of VEGF staining was more intense in Stage III tumors than those in Stage I/II (P < 0.0001). The mean number of involved lymph nodes in tumors with high VEGF staining intensity was significantly greater than in those with low staining intensity (P = 0.031). Survival analysis showed a significant correlation between high levels of VEGF staining intensity and poor disease-specific survival (P < 0.0001), with independent prognostic significance in multivariate analysis (RR = 3.5, P < 0.0001). In addition, patients with Stage II disease and high staining intensity of VEGF had a significantly worse disease-specific survival than those with low staining intensity (P = 0.001).
VEGF expression in colorectal cancer seems to be an independent prognostic marker of tumor behavior and may be useful to identify patients with unfavorable clinical outcome.
血管内皮生长因子（VEGF）在结直肠癌中的预后价值仍不明确，正如文献中报道的结果不一致所显示的那样。本研究的目的是检测VEGF在结直肠腺癌中的表达，并探讨其预后相关性。
通过对组织芯片进行免疫组织化学检测，在117例结直肠癌标本系列中研究VEGF表达。使用半自动计算机图像分析对肿瘤细胞胞质中的VEGF染色强度进行定量，并与各种临床病理特征和生存率相关联。
所有评估的肿瘤均显示VEGF表达，根据染色强度进一步分为49例高表达肿瘤和68例低表达肿瘤。有淋巴结转移的肿瘤中，VEGF染色强度比无淋巴结转移的肿瘤更强（P < 0.0001）。此外，III期肿瘤中VEGF染色强度比I/II期肿瘤更强（P < 0.0001）。VEGF染色强度高的肿瘤中受累淋巴结的平均数量显著多于染色强度低的肿瘤（P = 0.031）。生存分析显示，VEGF染色强度高与疾病特异性生存率低之间存在显著相关性（P < 0.0001），在多变量分析中具有独立的预后意义（RR = 3.5，P < 0.0001）。此外，II期疾病且VEGF染色强度高的患者的疾病特异性生存率显著低于染色强度低的患者（P = 0.001）。
结直肠癌中VEGF表达似乎是肿瘤行为的独立预后标志物，可能有助于识别临床结局不佳的患者。
