Chaudhri, S.; Jain, K.; Arthur, H.M.; Bennett, M.K.; Horgan, A.F.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA89
Academic Journal
Introduction: Preoperative radiotherapy is now the accepted treatment for a subgroup of patients with rectal cancer who are at high risk for local recurrence and poor survival. At present cross-sectional imaging is the only preoperative means of identifying this high risk subgroup. Rectal tumours with high microvessel density (MVD) in the resected specimen have been shown to be associated with poor survival. The aim of this study was to compare angiogenesis using MVD in preoperative endoscopic rectal cancer biopsy specimens (PERCBS) with the corresponding resected cancer specimen. Methods: Immunohistochemistry using CD31 monoclonal antibody was undertaken on paraffin sections from preoperative biopsies and microvessel density was compared with corresponding resected tumours from 25 patients with rectal cancer. Statistical analysis was done using linear regression and paired t test. Results: In patients who had not undergone radiotherapy prior to surgery there was a highly significant correlation (p < 0.0001; r² = 0.812) between MVD in biopsies (range 35-231/µm²; median 118) and resected tumour specimens (range 27-177/µm²; median 112). MVD was significantly lower in post radiotherapy resected specimens compared with PERCBS (p < 0.0255). Conclusion: Our results suggest that MVD in PERCBS is a reliable predictor of tumour MVD and could also provide useful prognostic tool with implication for planning of adjuvant of radiotherapy. Also in this study preoperative radiotherapy appears to downstage angiogenic activity as assessed by MVD, the significance of which will need further investigation.


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