Clinical Significance of Plasma Level of Vascular Endothelial Growth Factor-C in Patients with Colorectal Cancer

Objective: Vascular endothelial growth factor (VEGF)-C is known to be associated with angiogenesis and lymphangiogenesis in various cancers. However, little is known about the clinical significance of determining the blood level of VEGF-C in patients with colorectal cancer. Methods: Plasma levels of VEGF-C in patients with colorectal cancer (n 127) and normal healthy volunteers (n 23) were determined by the sandwich enzyme-linked immunosorbent assay. Results: The plasma VEGF-C concentration did not significantly differ between patients with colorectal cancer and healthy controls (P 0.53). However, subgroup analysis showed that deeper tumor invasion (P 0.04), more severe lymphatic invasion (P 0.03) and venous invasion (P, 0.01) were correlated with an elevated level of plasma VEGF-C. Among the patients (n 109) who underwent potentially curative surgery, the plasma level of VEGF-C was higher in patients who developed recurrence (n 35) than in those who did not (n 74) (P 0.04). In addition, disease-free (P 0.02) and overall survival times (P 0.02) were shorter in patients with a high level (.1840 pg/ml) of plasma VEGF-C than in those with a low level (1840 pg/ml) when the cut-off value was determined on the basis of the median value in colorectal cancer patients. Multivariate analysis with the Cox proportional hazard model demonstrated that the plasma VEGF-C level along with Dukes ’ stage was an indepen-dent factor affecting overall survival (P 0.03). Conclusion: These results suggest that determining the plasma level of VEGF-C would be useful for predicting lymphatic invasion, venous invasion and poor outcome of patients with colorectal cancer. Key words: vascular endothelial growth factor-C (VEGF-C) – colorectal cancer – prognosi