2000 Volume 53 Issue 1 Pages 27-34
It has been reported that hematogenic metastasis often occurs in colorectal cancer with VEGF expression. The purpose of this study was to elucidate the significance of VEGF as a prognosticator for colorectal cancer. The cases of 156 patients with stage I -III colorectal cancer were reviewed. The correlation between VEGF expression and the hematogenic recurrence rate, and survival rate for patients with colorectal cancer were analyzed. The expressions of VEGF and microvessel were determined by immunohistochemical staining.
The 5-year survival rate for VEGF+ patients was 67.8%, and that for VEGF- patients was 85.7% ; the difference was significant. Twenty-two of 72 (31%) patients who were positive for VEGF and 11 of 84 (13%) patients who were negative for VEGF had hematogenic recurrence; the difference was significant. Microvessel density was high in patients with hematogenic recurrence and in VEGF+ patients. Serum CEA value was the most significant variable in the multivariate analysis of the clinicopathological prognostic factors in colorectal cancer. The 5-year survival rate for VEGF+/CEA+ patients was 47.2%, which was significantly lower than that for VEGF+/CEA-, VEGF-/CEA+, and VEGF-/CEA- patients. Eighteen (50%) of the 36 VEGF+/CEA+ patients had hematogenic recurrence, which was significantly higher than the hematogenic recurrence rate in VEGF+/CEA-, VEGF-/CEA+, and VEGF-/CEA- patients. Thus the combination criterion of VEGF and serum CEA value should be a useful pronosticator for colorectal cancer, and the prognosis of VEGF+/CEA+ patients was quite poor.
