Study of endothelin-1 and vascular endothelial growth factor in patients with cancer colon

Abstract EN

Purpose : The levels of endothelin-1 and VEGF were evaluated in the sera of newly diagnosed patients with cancer colon and were compared with the routinely used tumor markers; CEA and CA19.9.

Their relations with some prognostic factors of cancer colon were also investigated.

Subjects and Methods : The study included 48 patients with cancer colon and 20 apparently healthy volunteers as a control group.

Patients were 23 males and 25 females with age range from 18 to 71 years (mean = 47±1.8).

Both serum and plasma samples were obtained from patients and controls.

Results : Six percent of patients had grade 1 tumors, 77% had grade 2 and 17% had grade 3 disease.

As regard to the stage, 52% of patients were stage II, 35.5% were stage III, while 12.5% were stage IV.

Liver metastasis was present in 12.5%, while 35% showed lymph node metastasis.

The VEGF, endothelin-1, CA19.9 and CEA were significantly higher in the cancer colon patients than in control groups (p-value <0.001, 0.006, <0.001 and <0.001; respectively).

Plasma level of endothelin-1 and serum level of VEGF showed significantly higher levels in advanced stages of the disease (p value <0 .001) and in presence of liver metastasis (p value <0.00l & 0.002 respectively), while VEGF showed significant result when compared with the grade (p value=0.032).

In this study, when comparing the levels of plasma endothelin-1 and serum VEGF between the metastatic, non-metastatic liver patients of the cancer colon group and the control group, the comparison was statistically significant for both markers (p<0.001).

Endothelin-1 and VEGF showed significant positive correlation (r=0.77 and p-value <0.0001).

Serum VEGF and CA19.9 showed good sensitivities which were not different (97.9% and 87.5%; respectively), while there was no significant difference between VEGF, CA19.9 and CEA with respect to specificities (100%, 90% and 100% respectively).

Conclusion : Both endothelin-1 and VEGF may be used for early detection of liver metastasis in cancer colon and VEGF may be used as a potential new marker for the diagnosis of cancer colon.

Further studies with larger number of patients are recommended to establish the value of VEGF and endothelin- 1 as potential diagnostic and prognostic markers for cancer colon.