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Is Microvessel Density a Prognostic Marker in Stage II and III Colon Cancer?

By: Sara Tewksbury
Posted: Wednesday, October 16, 2019

A study conducted by Sjoerd H. den Uil, MD, MSc, of Amsterdam University Medical Centre, and colleagues aimed to analyze the prognostic value of microvessel density in patients with stage II and III colon cancer. The findings were published in BMC Gastroenterology.

“Microvessel density appeared to be an independent prognostic factor associated with poor disease-free survival in stage II colon cancer patients, and with better disease-free survival in stage III colon cancer patients who were treated with adjuvant fluorouracil-based chemotherapy afterward. This latter observation may be of particular clinical interest, pending further validation,” the researchers concluded.

Colon cancer tissues were collected from 53 patients with stage II and 54 patients with stage III colon cancer, and the investigators scored microvessel density by digital morphometric analyses of CD31-stained whole tumor sections. The tumor-stroma percentage was scored using hematoxylin-eosin–stained slides. Immunohistochemical evaluation of tissue microarrays was used to determine protein expression of HIF1A and VEGFA.

The median microvessel density was measured to be higher in patients with stage III colon cancer than in those with stage II colon cancer. The samples were formalin-fixed paraffin-embedded tissues. The researchers observed that patients with high microvessel density also tended to have poor disease-free survival. However, patients with high microvessel density in patients with fluorouracil-treated stage III disease had better disease-free survival.

Dr. den Uil and colleagues suggested that as the disease progresses from stage I to stage IV, angiogenesis and microvessel density increase to meet the needs of the growing tumor. In addition, they observed the prognostic value of microvessel density in multivariate analyses for both cancer stages.

Disclosure: The study authors reported no conflicts of interest.

 



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