The angiogenesis in colorectal carcinomas with and without lymph node metastases.
Many clinical trials revealed that the anti-angiogenic treatment could improve prognosis in patients with metastatic colorectal carcinomas (CRC), when added to standard chemotherapy. In this paper, we tried to find out if the microvascular density (MVD) determined with CD31, CD105 was correlated with lymph node status, and if the intensity of angiogenesis was different in right versus left colon segments. We studied 187 CRC, with and without lymph node metastases, 128 from left and 59 from right colon.


RESULTS
In the right colon, the MVD was higher in the cases where the lymph nodes did not present metastases (pN0) but also when four or more lymph nodes were involved (pN2). In the rectum and sigma, the angiogenesis presented the highest intensity in pN0 and pN1 stage (1-3 lymph nodes with metastases), decreasing in pN2 stage. In the descendent colon segment, the MVD did not present differences between the cases with and without lymph node metastases.


CONCLUSIONS
Our study reveals that the most indicated cases for antiangiogenic treatment seem to be the pN0 and pN1 cases in the rectum and sigma, respectively pN0 and pN2 cases in the right colon. We tend to believe that the angiogenesis intensity in CRC is higher in early-stages of the tumoral proliferation but it is not an increasing process, having rather an oscillating character. Therefore, the angiogenesis remains an independent prognostic and predictive factor and the antiangiogenic treatment is necessary to be individualized for each patient.
Gurzu
Simona
S
Department of Pathology, University of Medicine and Pharmacy, Targu Mures, Romania. simonagurzu@yahoo.com
Jung
J
J
Azamfirei
L
L
Mezei
T
T
Cîmpean
Anca Maria
AM
Szentirmay
Z
Z
D015703:Antigens, CD / Q000378:metabolism; D002277:Carcinoma / Q000098:blood supply* / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D003106:Colon / Q000098:blood supply / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D000071063:Endoglin; D006801:Humans; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000378:metabolism; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000378:metabolism; D012007:Rectum / Q000098:blood supply / Q000378:metabolism
D015703:Antigens, CD; C064206:ENG protein, human; D000071063:Endoglin; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D011956:Receptors, Cell Surface