Correlation of Vascular Endothelial Growth Factor Expression and Neovascularization with Colorectal Carcinoma: A Pilot Study

Abstract

Background: In Egypt, there is an increasing incidence of colorectal cancer (CRC), especially among patients under 40 years of age, affecting a very important age group in our community. The basic pathogenic step in the process of tumor growth, invasion and metastasis is tumor induced angiogenesis. The aim of this study was to evaluate the angiogenesis in colorectal carcinoma by detect the expression of VEGF vascular endothelial growth factor and micro vascular density (MVD) determination with IHC (immunohistochemistry) method and to determine if and how angiogenesis correlates with clinicopathologic parameters. Methods and findings: Sixty five archival, paraffin embedded tissue samples of colorectal carcinoma from Pathology Lab of Suez Canal University Teaching Hospital (Egypt) with complete follow-up files in Oncology Unit from. VEGF and micro vessels were identified immunohistochemically, using monoclonal VEGF antibody and CD34 antibody, respectively. VEGF IHC expression was positive in 94.7% of cases and MVD ranged from 9 to 42 mean 24.55 ± 13.79. A significant positive relation was found between VEGF expression; and histological type, tumor grade, lymph node (LN) involvement, UICC TNM classification, perineural and lympho-vascular invasions (p<0.05). A significant positive relation was found between VEGF expression and MVD (p<0.001). There is a significant correlation has been found between MVD and size of the tumor, histological subtype, tumor grade, LN involvement, UICC TNM classification, vascular and perineural invasion and survival (p<0.05). Conclusions: This study has highlighted the prognostic significance of VEGF and MVD to predict survival in CRC patients, as well as some of traditional prognostic factors as tumor histologic type, tumor size, tumor grade, LN involvement, tumor stage and lympho-vascular and perineural invasion to identify patients at high risk for relapse who may benefit from adjuvant treatment including new therapeutic strategies in the future.