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- Title
PREDICTIVE AND PROGNOSTIC IMPORTANCE OF NEOVASCULARISATION IN COLORECTAL CARCINOMA.
- Authors
Banjin, Maja; Bilalović, Nurija; Obralić, Nermina; Lincender, Lidija
- Abstract
Identification of patients with stage II/III colorectal cancer (CRC) who should receive treatment is complex. Tumour microvessel density (MVD) is prognostic in CRC since the degree of tumour vascularisation influences its evolution. Consequently, patients with high MVD have a poor prognosis. This retrospective analysis assessed the prognostic value of MVD levels, measured using monoclonal antibodies for CD105 and the panendothelial marker CD34, and other prognostic factors (Aster Coller ŠACĆ stage, T stage, histology) in identifying patients suitable for antiangiogenic treatment in the adjuvant treatment of CRC. MVD was immunohistochemically assessed in tumour samples using monoclonal antibodies for CD34 and CD105. Dunnett and ANOVA tests were used for multiple comparisons of dependent variables. Statistically significant parameters were included in the analysis of patients with CRC in order to establish guidelines for the treatment of those with stage II and III of disease. Out of 57 patients included, 36 are still alive. Median MVD was 24 (range 8-78) using anti-CD34 and 7 (range 0-15) for anti-CD105; only CD105-positive MVD correlated with overall survival (OS). For OS, T3 and AC stage C1 were prognostic values; T3 and C1 were cross-section points between prognostic groups. No statistically significant value was obtained for histology grade. A CD105-positive MVD of 9 was a statistically significant predictive value for OS and MVC=9 was the cross-section between two prognostic groups. Three risk groups were identified: low-risk Group I patients (T<3, AC C<1 and CD105 <9) who should not receive adjuvant treatment after surgery; Group II patients (T3, AC C1 and CD105=9) who should receive adjuvant, standard treatment (Mayo Protocol +/- radiotherapy) after surgery; and high-risk Group III patients (T>3, AC C>1 and CD105>9) who require FOLFOX or XELOX and should be considered for adjuvant antiangiogenesis therapy. Conclusions: Intratumour neovascularisation is predictive for CRC patients at a high risk for metastatic disease. CD105 immunostaining, combined with known risk factors, may help to identify patients with poorer prognosis. Prospective, randomized studies are needed to validate these results.
- Subjects
NEOVASCULARIZATION; COLON cancer prognosis; RETROSPECTIVE studies; MONOCLONAL antibodies; TUMOR markers; ANTINEOPLASTIC agents; CANCER patients
- Publication
Medical Journal / Medicinski Žurnal, 2011, Vol 17, Issue 3, p202
- ISSN
1512-5866
- Publication type
Article