KOLO-REKTAL KANSERLERDE VASKÜLER ENDOTELİAL BÜYÜME FAKTÖRÜ (VEBF) EKSPRESYONUNUN PROGNOZ ÜZERİNE ETKİSİ

Year 2005, Volume: 18 Issue: 2, 53 - 58, 29.06.2015

Deniz Durak Asım Cingi Manuk Manukyan Handan Kaya Ahmet Aktan Cumhur Yeğen

Abstract

Amaç: Adjuvan tedaviden fayda görebilecek kolorektal kanserli hastaları seçebilmek için histopatolojik evrelemeye ek olarak yeni
prognostik belirteçlere ihtiyaç duyulmaktadır. Kolorektal kanserlerde ise anjiogenezin prognoz üzerine etkisi halen tartışmalıdır.
Yöntem: Modifiye-Astler-Coller Evre A-B olarak histopatolojik tanı almış 119 hasta belirlenmiş ve düzenli takipleri olan, 41 hasta
çalışmaya alınmıştır. Bu hastaların 16 tanesinde lokal rekürrens veya uzak metastaz tespit edilmiştir. VEBF ekspresyonu anti-rabbit
immunoglobulin boyaması yöntemiyle belirlenmiştir.
Bulgular: VEBF ekspresyonu negatif olan grupta 5 yıllık yaşam %83.33, VEBF ekspresyonu pozitif olan grupta ise 5 yıllık yaşam
%82,13 olarak bulunmuştur. VEBF ekspresyonu ile tümör yerleşimi, tümör derecesi, pT evresi, angio-nöral-lenfatik invazyon, lokal nüks
ve uzak metastaz ve 5 yıllık sağ kalım arasında anlamlı bir bağlantı tespit edilememiştir. Ancak kitle dışı klinik bulgular ile başvuran
hastalarda, sağ kalım açısından anlamlı fark bulunmuştur (p=0.003).
Sonuç: Bu çalışma sonucuna göre evre A-B kolo-rektal kanserlerde immünhistokimyasal yöntemle anjiogenez belirlenmesinin
prognostik önemi gösterilememiştir.

Keywords

Anjiogenez, Vasküler endotelial büyüme faktörü, Kolon kanseri

References

• 1. Haier J, Nasralla M, Nicolson GL. Cell surface molecules and their prognostic values in assessing colorectal carcinomas. Ann Surg 2000; 231: 11-24.
• 2. Steele GD, Mayer RJ. Adenocarcinoma of the colon and rectum.In: Shackelford’s surgery of the alimentary tract. 4th ed. Philadelphia: WB Saunders,1996:124-139.
• 3. Andre T, Kotelevets L, Vaillant JC, et al. Vegf, Vegf-B, Vegf-C and their receptors KDR,FLT-1 and FLT-4 during the neoplastic progression of human colonic mucosa. Int J Cancer 2000; 86: 174-181.
• 4. Compton CC.Updated protocol for the examination of specimens from patients with carcinomas of the colon and rectum excluding carcinoid tumors, lymphomas, sarcomas,and tumors of the vermiform appendix: a basis for checklists. Cancer Committee. Arch Pathol Lab Med 2000; 124:1016-1025.
• 5. Burdy G ,Panis Y, Alves A, Nemeth J, Lavergne-Slove A, Valleur P. Identifying patients with T3-T4 node negative colon cancer at high risk of recurrence. Dis Colon Rectum 2001;44:1682-688.
• 6. Folkman J. Tumor angiogenesis Therapeutic implications. N Eng J Med 1971;285:1182-1186.
• 7. Güllüoğlu M, Dizdaroğlu F. Tümör anjiogenezi, Ulusal Cerrahi Dergisi 2000; 16:279-290.
• 8. Saclarides TJ, Speziale NJ, Drab E, Szeluga DJ, Rubin DB. Tumor angiogenesis and rectal carcinoma. Dis Colon Rectum 1994; 37:921-926.
• 9. Frank RE, Saclarides TJ, Leurgans S, Speziale NJ, Drab EA, Rubin DB. Tumor angiogenesis as a predictor of recurrence and survival in patients with node negative colon cancer. Ann Surg 1995; 222:695-699.
• 10. Ishigami SI, Arii S, Furutani M, et al. Predictive value of VEGF in metastases and poor prognosis of human colorectal cancer. Brit J Cancer 1998; 78:1379-1384.
• 11. Cascinu S, Staccioli MP, Gasparini G, et al.. Expression of VEGF can predict event-free survival in stage II colon cancer. Clin Cancer Res 2000; 6:2803-2807.
• 12. Oh-e H, Tanaka S, Kitadai Y, Shimamoto F, Yoshihara M, Haruma K. Angiogenesis at the site of deepest penetration predicts lymph node metastasis of submucosal colorectal cancer. Dis Colon Rectum 2001; 44:1229-1236.
• 13. Lee JC, Chow NH, Wang ST, Huang SM. Prognostic value of VEGF expression in colorectal cancer patients. Eur J Cancer 2000; 36:748-753.
• 14. Gordon MS, Margolin K, Talpaz M, et al. Phase I safety and pharmacokinetic study of recombinant human antiVEGF in patients with advanced cancer. J Clin Oncol 2001;19: 843-850.
• 15. Banner BF, Whitehouse R, Baker SP, Swanson RS. Tumor anjiogenez in stage II colorectal carcinoma. Am J Clin Pathol 1998;109: 733-737.
• 16. Tokunaga T, Oshika Y, Abe Y, et al.. Vascular endothelial growth factor mRNA isoform expression pattern is correlated with liver metastasis and poor prognosis in colon cancer. Brit J Cancer 1998;77:998- 1002.
• 17. Konno H, Tanaka T, Baba M, et al. Quantitative analysis of vasculer endothelial growth factor in colon cancer. Eur Surg Res 1998; 30;273-278.
• 18. Langlois N, Walker LG, Smith I, Skinner L, Eremin O, Heys SD. Expression of growth factor receptors is not a prognostic indicator in young patients with colo-rectal cancer. J Roy Coll Surg Edin 1997; 42:98-101.
• 19. Wolmark N, Wieand HS, Rockette HE, et al. The prognostic significance of tumor location and bowel obstruction in Dukes B and C colorectal cancer. Findings from the NSABP clinical trials. Ann Surg 1983; 198:743-752.
• 20. Gervaz P, Bouzourene H, Cerottini JP, et al. Dukes B colorectal cancer: distinct genetic categories and clinical outcome based on proximal or distal tumor location. Dis Colon Rectum 2001;44:364-373.
• 21. Steinberg SM, Barkin JS, Kaplan RS, Stablein DM. Prognostic indicators in colon tumors. The Gastrointestinal Tumor Study Group experience. Cancer 1986;57:1866-1870.
• 22. Takahashi Y, Tucker SL, Kitadai Y, et al. Vessel counts and expression of vasculer endothelial growth factor as prognostic factors in node negative colon cancer. Arch Surg 1997;132: 541-546.
• 23. Engel CJ, Bennett ST, Chambers AF, Doig GS, Kerkvliet N, O'Malley FP. Tumor angiogenesis predicts recurrence in invasive colorectal cancer when controlled for Dukes staging. Am J Surg Pathol 1996; 20:1260- 1265.