Introduction: Invasion and metastasis are the most
life-threatening aspects of the colorectal neoplastic process. Many studies
have shown that invasion, metastasis, and solid tumour growth are dependent on
new blood vessel formation from established vasculature. According to data from
the Kampala Cancer Registry in Uganda, the number of instances of colorectal
cancer (CRC) has increased in this area, and patients are presenting at an
advanced stage and younger ages. A
relationship between tumour growth, distant metastasis, and a poor prognosis
with an increased expression of VEGF has been reported in studies.
Aim: The aim of this study was to analyse the correlation of VEGF
with the clinicopathological characteristics of Ugandan patients with
colorectal cancer.
Methods: Immunohistochemistry was carried out on fifty-two
patients’ paraffin-embedded tissue blocks of CRC between 2008–2021. VEGF
expression was detected using the indirect immunoperoxidase method which used
monoclonal antibody VEGF, DAKO Agilent USA, Clone VG1, and reference M7273. The
haematoxylin and eosin stains were used to evaluate the grade, lymphovascular
invasion status, and histopathological subtypes of CRC. The demographic data,
staging, and topography of the tumours were obtained from the clinical
patients’ files and the Kampala Cancer Registry. The biopsy specimens were
obtained during colonoscopy and the resected colorectal specimens at operation.
Using a standard pretested Data Extraction Form, data for all tissue samples
was extracted from the clinical patients’ files in the respective hospitals and
the Kampala Cancer Registry.
Results: Out of fifty-two CRC participants, there were 7(43.7%)
participants with stage IV disease compared to 2(12.5%) with stage I disease
and this reached statistical significance (p=0.0479). There were 11(68.8%)
participants with grade II disease compared to 2(12.5%) with grade I disease
from those that stained positively for VEGF (p=0.0012). Classical
adenocarcinoma constituted 13(81.3%) participants compared to 3(18.8%) mucinous
adenocarcinomas and signet ring colorectal carcinoma from those that stained
positively for VEGF (p=0.0000). CRC grading was negatively correlated with
VEGF-1 expression (r=-0.0565) (p=0.7091). The mechanism responsible for increasing
the results of chemotherapy with anti-VEGF therapy is not entirely understood.
However, tumour apoptosis may be increased with the inhibition of angiogenesis.
Conclusions: There was a tendency to increase the expression of
VEGF with increasing stages of CRC. A poor prognosis and increased VEGF-1
expression were substantially correlated with the existence of metastases. More
effective medical interventions for colorectal cancer in Uganda are required,
utilizing chemotherapy and anti-VEGF drug combinations.
Author(s) Details
Richard
Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka,
Uganda, Department of Surgery, Faculty of Health Sciences, Equator University
for Science and Technology, Masaka, Uganda, Department of Surgery, Faculty of
Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda,
Department of Pathology, School of Biomedical Sciences, College of Health
Sciences, Makerere University, Kampala, Uganda and Department of Surgery,
Mulago National Referral Hospital, Kampala, Uganda.
Julius
Kiwanuka
Department of Epidemiology and Biostatistics, School of Public
Health, College of Health Sciences, Makerere
University, Kampala, Uganda.
Josephat
Jombwe
Department of Surgery, Mulago National Referral Hospital, Kampala,
Uganda.
Emmanuel
Elobu
Department of Surgery, Mulago National Referral Hospital, Kampala,
Uganda.
Henry
Wabinga
Department of Pathology, School of Biomedical Sciences, College of
Health Sciences, Makerere University,
Kampala, Uganda.
Michael
Odida
Department of Pathology, School of Biomedical Sciences, College of
Health Sciences, Makerere University, Kampala, Uganda and Department of
Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda.
Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v2/1622
