Correlation between Angiogenesis Degree & Recurrence of Colon Cancer

Yu, Chang Sik; Lee, Kang Hong; Lee, Han Il; Kim, Young Min; Gong, Gyoung Yub; Kim, Jin Cheon

Abstract

BACKGROUND AND AIMS: Angiogenesis is needed for tumor growth and metastasis. The proliferating endothelial cells may secrete growth factor that stimulate tumor growth. Their porous basement membranes may be a port of entry by cancer cell. The purpose of this study was to find out relationship between angiogenesis degree and growth or recurrence of colon cancer.
METHODS
Immunohistochemical staining by monoclonal IgG1 antibody to factor VIII related antigen was made using archival tissue of curatively resected 97 Dukes B & C colon cancer patients. Rectal and hereditary colon cancer patients were excluded for standardization of recurrence. Angiogenesis score was defined as a tnean of 3 separate light microscopic field (x 200) by two pathologists. Median follow-up period was 42 months.
RESULTS
Mean angiogenesis score was 21.7 (14-34). There was no difference between angiogenesis score and tumor size, Dukes stage, differentiation and preoperative CEA level. Overall recurrence was not affected by angiogenesis score. Confining to stage Dukes B, angiogenesis score of recurrence group should be 24.8, while non-recurrence group 20.5 (p=0.006). In Dukes C stage, there was no difference (recurrence group: 21.2, non-recurrence group: 22.5). A significant difference was also found between recurrence patterns of Dukes B (non-recurrence group: 20.5, locoregional recurrence group: 25.7, systemic recurrence group: 24.3) (p=0.02). Five year survival rates were 91% in low angiogenesis score (22) group and 74% in high angiogenesis score () 22) group. However, there was no statistical difference. Comparing the survival rate in Dukes B stage only, high angiogenesis score group showed poor 5 year survival rate (68% vs 100%, p=0.04).
CONCLUSIONS
In node negative colon cancer, angiogenesis degree may be an independent prognostic factor and selective use of adjuvant therapy may validate in patients with high angiogenesis score.