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Microvessel density as new prognostic marker after radiotherapy in rectal cancer.

Svagzdys S, Lesauskaite V, Pavalkis D, Nedzelskiene I, Pranys D, Tamelis A - BMC Cancer (2009)

Bottom Line: MVD was significantly lower in the group of patients treated with a long course of RTX (p <0.025).In long RTX group we found a significant prognostic rate for MVD when the density cut off was near 130 with 92.3% sensitivity and 64.7% specificity.Further investigations are now needed to determine the changes in angiogenesis during a shorter course of RTX.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unit of Coloproctology, Department of Surgery, Kaunas Medical University Clinics, Eiveniu 2, Kaunas, Lithuania. s.svagzdys@gmail.com

ABSTRACT

Background: The extent of angiogenesis is an important prognostic factor for colorectal carcinoma, however, there are few studies concerning changes in angiogenesis with radiotherapy (RTX). Our aim was to investigate changes in tumor angiogenesis influenced by radiotherapy to assess the prognostic value of angiogenesis the microvessel density (MVD) in overall survival after radiotherapy.

Methods: Tumor specimens were taken from 101 patients resected for rectal cancer. The patients were divided into three groups according to the treatment they received before surgery (not treated, a short course, or long course of RTX). Tumor specimens were paraffin-embedded and immunohistochemistry was performed with primary antibody against CD-34 to count MVD.

Results: MVD was significantly lower in the group of patients treated with a long course of RTX (p <0.025). The mean MVD for the long RTX group was 134.8; for the short RTX group - 192.5; and for those not treated with RTX - 193.0. There were no significant statistical correlations between MVD and age, sex, grade of tumor differentiation (G) and tumor size (T) in those untreated with RTX. In long RTX group we found a significant prognostic rate for MVD when the density cut off was near 130 with 92.3% sensitivity and 64.7% specificity. When the MVD was lower than a cut off of 130, the survival period significantly increased (p = 0.001), the mortality rate is significantly higher if the MVD is higher than 130 (microvessel/mm2) (1953.047; p = 0.002), if the histological grade is moderate/poor (127.407; p = 0.013), if the tumor is T3/T4 (111.618; p = 0.014), and if the patient is male (17.92; p = 0.034) adjusted by other variable in model.

Conclusion: Our results show that a long course of radiotherapy significantly decreased angiogenesis in rectal cancer tissue. MVD was found to be a favourable marker for tumor behaviour during RTX and a predictor of overall survival after long course of RTX. Further investigations are now needed to determine the changes in angiogenesis during a shorter course of RTX.

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Diagram of ROC curves for patients who received long course of radiotherapy. Area 84.2%; p = 0.003.
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Figure 4: Diagram of ROC curves for patients who received long course of radiotherapy. Area 84.2%; p = 0.003.

Mentions: The ROC test was made to discover the MVD cut-off which displayed a high risk of mortality after long RTX (Figure 4). The cut-off is 130 microvessel/mm2. We obtained 90.9% sensitivity and 70.6% specificity of MVD when the cut-off is 130.


Microvessel density as new prognostic marker after radiotherapy in rectal cancer.

Svagzdys S, Lesauskaite V, Pavalkis D, Nedzelskiene I, Pranys D, Tamelis A - BMC Cancer (2009)

Diagram of ROC curves for patients who received long course of radiotherapy. Area 84.2%; p = 0.003.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2666763&req=5

Figure 4: Diagram of ROC curves for patients who received long course of radiotherapy. Area 84.2%; p = 0.003.
Mentions: The ROC test was made to discover the MVD cut-off which displayed a high risk of mortality after long RTX (Figure 4). The cut-off is 130 microvessel/mm2. We obtained 90.9% sensitivity and 70.6% specificity of MVD when the cut-off is 130.

Bottom Line: MVD was significantly lower in the group of patients treated with a long course of RTX (p <0.025).In long RTX group we found a significant prognostic rate for MVD when the density cut off was near 130 with 92.3% sensitivity and 64.7% specificity.Further investigations are now needed to determine the changes in angiogenesis during a shorter course of RTX.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unit of Coloproctology, Department of Surgery, Kaunas Medical University Clinics, Eiveniu 2, Kaunas, Lithuania. s.svagzdys@gmail.com

ABSTRACT

Background: The extent of angiogenesis is an important prognostic factor for colorectal carcinoma, however, there are few studies concerning changes in angiogenesis with radiotherapy (RTX). Our aim was to investigate changes in tumor angiogenesis influenced by radiotherapy to assess the prognostic value of angiogenesis the microvessel density (MVD) in overall survival after radiotherapy.

Methods: Tumor specimens were taken from 101 patients resected for rectal cancer. The patients were divided into three groups according to the treatment they received before surgery (not treated, a short course, or long course of RTX). Tumor specimens were paraffin-embedded and immunohistochemistry was performed with primary antibody against CD-34 to count MVD.

Results: MVD was significantly lower in the group of patients treated with a long course of RTX (p <0.025). The mean MVD for the long RTX group was 134.8; for the short RTX group - 192.5; and for those not treated with RTX - 193.0. There were no significant statistical correlations between MVD and age, sex, grade of tumor differentiation (G) and tumor size (T) in those untreated with RTX. In long RTX group we found a significant prognostic rate for MVD when the density cut off was near 130 with 92.3% sensitivity and 64.7% specificity. When the MVD was lower than a cut off of 130, the survival period significantly increased (p = 0.001), the mortality rate is significantly higher if the MVD is higher than 130 (microvessel/mm2) (1953.047; p = 0.002), if the histological grade is moderate/poor (127.407; p = 0.013), if the tumor is T3/T4 (111.618; p = 0.014), and if the patient is male (17.92; p = 0.034) adjusted by other variable in model.

Conclusion: Our results show that a long course of radiotherapy significantly decreased angiogenesis in rectal cancer tissue. MVD was found to be a favourable marker for tumor behaviour during RTX and a predictor of overall survival after long course of RTX. Further investigations are now needed to determine the changes in angiogenesis during a shorter course of RTX.

Show MeSH
Related in: MedlinePlus