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Abstract: Aims: Vascular endothelial growth factor (VEGF) over-expression is frequently considered as a marker of both, a poor prognosis and of an aggressive tumour phenotype. Colorectal carcinoma is still one of the most lethal malignancies. Thus, our purpose was to study the expression of VEGF in tumour tissue (VEGFt) and in the tissue surrounding tumours (VEGFnt) and analyse its correlation with clinico-pathological features and overall survival. Methods: The study was designed to determine the concentration of vascular endothelial growth factor in tumour (n = 87) and non-tumour tissue (n = 230) obtained form the colorectal cancer patients. Accordingly, VEGF expression was studied in tissue homogenates by a quantitative sandwich ELISA method. Results: The study was performed on 317 colorectal samples from 87 colorectal cancer patients. VEGF expression was higher in the tumour than in the non-tumour area (P < 0.0005). In areas of 5–10 cm around the tumours, VEGF expression was higher than the expression obtained in proximal or distal edge of the resection. VEGFt expression was lower in patients with stage I than in patients with stage II, III, or IV. However, a shorter overall survival time was evident when the ratio obtained between VEGF expression in the tumour and mean VEGF expression in the non-tumour areas of the same patient (VEGFt/VEGFnt ratio) was ≤2 (P = 0.019). Conclusions: VEGF expression in colorectal cancer tissue was higher in tumour than in non-tumour areas. VEGFt expression was lower in initial clinical stages. Indeed, patients who presented a VEGFt/VEGFnt ratio >2 survived longer. This is the first report showing that the clinical outcome could be related to the VEGFnt over-expression in colorectal cancer patients. [Copyright &y& Elsevier]

Background: An important goal of serum tumor marker research is to provide a test for detecting cancer in early stages. Expression of carbohydrate antigen (CA) 19.9 has been described in various malignancies., Methods: The possible prognostic value measuring cytosol CA 19.9 expression in tumors was evaluated in a study of 63 colorectal carcinoma (CRC) patients who were followed for at least 2 years. CA 19.9 expression in cytosol was determined by enzyme-linked immunoadsorbant assay, and measurement of this protein achieved by quantitative assay., Results: Mean levels of cytosol CA 19.9 found in tumor samples were significantly higher than those in nontumoral areas in CRC patients (P<0.0005). Patients with more than 3 positive lymph nodes had a higher expression of the marker (P<0.05). Univariate and multivariate analyses revealed that cytosol CA 19.9 concentration was an independent prognostic variable for relapse. Furthermore, the probability of relapse increased 4.2 times for every increase in cytosol tumor marker of 5000 U/mg, and tumors located in the rectum had a probability of relapse 9.5 times greater., Conclusions: Cystol CA 19.9 expression in CRC can be an independent prognostic factor for relapse. Patients with high levels of CA 19.9 have worse prognosis than those with lower values. Therefore, this group of patients should receive special management with regard to their follow-up and treatment. Moreover, quantitative cytosol tumor marker measurement is an easy and highly effective method for determining the prognoses of CRC patients., (Copyright 1999 American Cancer Society.)