Clinical Study on the Expression of VEGF in Liver Metastases of Colorectal Cancer and Its Effect on Prognosis
|School||Dalian Medical University|
|Keywords||Colorectal Cancer Shift VEGF Targeted therapy|
Objective: To determine vascular endothelial growth factor (vascularendothelial growth factor, VEGF) in colorectal cancer and liver metastases in rats. VEGF and colorectal liver study the correlation, and then by exploring the primary tumor and liver metastases VEGF expression to find a suitable anti-VEGF targeted therapy for special populations. Methods: 48 patients were enrolled, including 22 cases of colorectal cancer after radical resection, adjuvant chemotherapy after specification (including 5-FU ± oxaliplatin at least 4 cycles), does not appear in patients with liver metastases; 12 cases with colorectal rectal cancer surgery, the standardized adjuvant chemotherapy in patients with liver metastases (both metachronous liver metastases); 14 cases of colorectal liver metastases simultaneously (including colorectal cancer liver metastases after 6 months) and accept the primary tumor and colorectal liver metastases resection of patients. Immunohistochemistry was used to detect colorectal cancer primary tumor, liver metastases, liver resection margin of normal tissue expression of VEGF, VEGF expression and analysis of clinicopathologic features and survival time. Results: VEGF in colorectal cancer, liver metastases, liver resection margin normal tissues, the positive expression rate was 58.3%, 64.20%, 30%, no significant difference (P gt; 0.05). VEGF expression and tumor stage, lymph node metastasis, liver metastasis, preoperative CEA levels associated (P lt; 0.05), with gender, age, histological type and grade, tumor size, liver metastases no correlation ( P gt; 0.05). In 48 cases of colorectal primary tumors, VEGF positive expression of disease-free survival (DFS), overall survival (OS) was significantly lower than the expression of VEGF-negative patients (P lt; 0.05). In 34 cases of postoperative adjuvant chemotherapy in patients with normal, VEGF positive expression of DFS, OS were lower than VEGF negative group (P lt; 0.05). Subgroup analyzes showed that in the absence of liver metastasis, metachronous liver metastasis and simultaneous liver metastasis, VEGF expression status of each group of DFS, OS had no effect (P gt; 0.05). In 26 cases of liver metastasis, VEGF expression state, DFS, OS had no effect (P gt; 0.05). Univariate analysis showed that age gt; 60 years of age, lymph node metastasis, preoperative CEA positive tumor Ⅲ or Ⅳ, hepatic metastases, VEGF positive impact on colorectal cancer patients were prognostic factors; significant single factor of the above The COX regression multivariate analysis, the prognosis of patients with colorectal liver metastases is an independent risk factor. Conclusion: VEGF expression and tumor stage, lymph node metastasis, preoperative CEA levels related, indicating the occurrence of VEGF in colorectal cancer development, can be used as a molecular indicator of condition assessment. The positive VEGF in liver metastases was significantly higher in patients with liver metastases does not appear to prove the primary tumor VEGF expression and colorectal cancer liver metastasis. The prognosis of colorectal cancer liver metastases is an independent risk factor, and VEGF expression can affect the survival time of colorectal cancer, suggesting that VEGF may also affect the prognosis of colorectal cancer is an independent risk factor. VEGF affecting the efficacy of adjuvant chemotherapy, suggesting that colorectal cancer patients with positive expression of VEGF in the crowd, consider the joint anti-VEGF targeted therapy.