VEGF expression predicts survival in patients with peritoneal surface metastases from mucinous adenocarcinoma of the appendix and colon
VEGF expression predicts survival in patients with peritoneal surface metastases from mucinous adenocarcinoma of the appendix and colon
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DOI：
10.1245/s10434-007-9699-7
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发表时间：
2008-03-01
影响因子：
3.7
通讯作者：
Ahmad, Syed A.
中科院分区：
文献类型：
--
作者：
Logan-Collins, Jocelyn M.;Lowy, Andrew M.;Ahmad, Syed A.
背景资料：卵巢癌转移灶中高水平的血管内皮生长因子（VEGF）与化疗患者的预后不良相关。VEGF导向治疗可提高转移性结直肠癌患者的生存率。转移到腹膜表面的粘液腺癌患者可以进行细胞减灭术治疗，肿瘤分级和细胞减灭状态都是预后因素。我们假设，血管生成指数可能是预后的患者进行细胞减灭术的粘液腺癌的阑尾和colon.Methods：从辛辛那提大学腹膜恶性肿瘤数据库的5年期细胞减灭的情况下进行了审查。CD 34计数应用免疫组化方法对粘液腺癌行肿瘤细胞减灭术和腹腔内温热灌注（IPHP）的患者标本中血管内皮生长因子（VEGF）的表达进行了评价。男26例，女9例，平均年龄50岁，32例为阑尾粘液腺癌，3例为结肠粘液腺癌，行肿瘤细胞减灭术和IPHP。平均随访18个月（范围1-63个月），23例疾病复发，12例存活无复发。平均生存期为19个月（范围1-63个月）。CD 34计数与复发或生存无关;然而，平均VEGF计数与生存相关（P = 0.017），并且，对于复发患者，这种相关性更强（P = 0.002）。结论：这些结果表明，肿瘤血管生成标志物可能预测粘液腺癌腹膜表面转移患者的生存。这些发现引发了一种假设，即抗血管生成疗法可能对这种毁灭性疾病的患者有效。
Background: High levels of vascular endothelial growth factor (VEGF) in ovarian cancer metastases are associated with a worse prognosis in patients treated with chemotherapy. VEGF-directed therapy improves survival for those with metastatic colorectal cancer. Patients with mucinous adenocarcinomas metastatic to the peritoneal surfaces can be treated with cytoreductive surgery, and both tumor grade and cytoreduction status are prognostic. We hypothesized that angiogenic indices may be prognostic in patients undergoing cytoreductive surgery for mucinous adenocarcinoma of the appendix and colon.Methods: Cytoreductive cases from a 5-year period from the University of Cincinnati peritoneal malignancy database were reviewed. CD 34 counts (blood vessels) and VEGF expression was evaluated by means of immunohistochemistry on specimens from patients undergoing cytoreductive surgery and intraperitoneal hyperthermic perfusion (IPHP) for mucinous adenocarcinoma.Results: A total of 26 males and 9 females, with a mean age of 50 years, underwent cytoreductive surgery and IPHP for mucinous adenocarcinoma of appendiceal (n = 32) or colonic (n = 3) origin. With a mean follow-up of 18 months (range 1-63 months), 23 had disease recurrence and 12 were alive without recurrence. The mean survival was 19 months (range 1-63 months). CD34 counts did not correlate with recurrence or survival; however, average VEGF counts correlated with survival (P = 0.017), and, for patients with recurrence, this correlation was stronger (P = 0.002).Conclusions: These results suggest that markers of tumor angiogenesis may predict survival in patients with peritoneal surface metastases from mucinous adenocarcinoma. These findings provoke the hypothesis that antiangiogenic therapies may be effective in patients with this devastating disease.