Clinical relevance of vascular endothelial growth factor-A in colorectal cancer

To study the expression status and clinical relevance of vascular endothelial growth factor-A (VEGF-A) in colorectal cancer (CRC) tissues.

VEGF-A expression was investigated by immunohistochemistry in 89 cases with CRC. Some demographic and histopathological variables were compared with VEGF-A expression to determine the prognostic significance in CRC.

VEGF-A (-) was found in 24 cases; (+), (++) and (+++) stainings were detected in 24, 35 and six cases, respectively. VEGF-A (-) was found in 20 of 58 cases with left colon cancer, while only four of 31 cases with right colon cancer were VEGF-A (-) (p=0.024). There was a trend for lower tumor grade and lesser serosal invasion in cases with VEGF-A (-) samples (p=0.07 and p=0.079, respectively). Although the correlation was not statistically significant, there was a trend for lower death rate in cases with VEGF-A (-) tumor (p=0.087). The longest survival was found in cases with VEGF-A (-) tumor and the shortest survival was found in cases with VEGF-A (+++) tumor. Median survival for patients with VEGF-A (-), (+), (++) and (+++) tumors was 59, 47, 35 and 11 months, respectively (p=0.02). The Cox proportional hazards model identified stage IV disease and VEGF-A (+++) tumor as having the most important influences upon overall survival (odds ratio: 5.1, 95% confidence interval: 2.0-13.0 and odds ratio: 3.6, 95% confidence interval: 1.0-12.7, respectively), followed by serosal invasion (odds ratio: 2.4, 95% confidence interval: 1.0-5.9).

This study shows that VEGF-A is a poor prognostic factor in cases with CRC, but the relatively small size of the study group precluded the correlation with the entire known prognostic indicator.