Impact of surgery and chemotherapy on von Willebrand factor and vascular endothelial growth factor levels in colorectal cancer.
BACKGROUND
von Willebrand factor (vWf) is thought to mediate binding of tumour cells to platelets and to favour their systemic spreading capacity. Platelets involved in tumour angiogenesis are capable of releasing vascular endothelial growth factor (VEGF). Hence, levels of vWf and VEGF may correlate with cancer stage. The objectives are determine the impact of surgery and chemotherapy on vWf and VEGF in colorectal cancer (CRC) patients.


METHODS
Twenty healthy volunteers (group 1), 14 patients with locally advanced CRC (group 2) and 12 patients with metastatic CRC (group 3) were enrolled. Blood samples were taken at recruitment in group 1, and before and after surgery and chemotherapy in groups 2 and 3, respectively. Blood levels of vWf, VEGF, platelet count, C-reactive protein (CRP), ceruloplasmin and carcinoembrionary antigen (CEA) were measured.


RESULTS
At baseline, group 3 showed higher concentrations of vWf than the other groups (p<0.05). In group 2, vWf became elevated 40% post-surgery (p=0.016), independently of changes in CRP or ceruloplasmin. In group 3, chemotherapy caused a 42% reduction in VEGF (p=0.015).


CONCLUSIONS
There was a strong correlation between higher vWf levels and more advanced CRC stage at diagnosis. These levels were elevated post-surgery in patients with locally advanced CRC. Chemotherapy significantly decreased VEGF in metastatic CRC patients before CEA showed any significant change.
Gil-Bazo
Ignasio
I
Departamento de Oncología, Clínica Universitaria, Universidad de Navarra, Pamploma, Spain. gilbazoi@mskcc.org [corrected]
Gil Bazo
Ignacio
I
Catalán Goni
Victoria
V
Catalán González
Victoria
V
Alonso Gutiérrez
Alvaro
A
Rodríguez Rodríguez
Javier
J
Páramo Fernández
José Antonio
JA
de la Cámara Gómez
Juan
J
Hernández Lizoain
José Luis
JL
García-Foncillas López
Jesús
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D014841:von Willebrand Factor / Q000032:analysis*
D042461:Vascular Endothelial Growth Factor A; D014841:von Willebrand Factor