ANGIOGENESIS ASSESSMENT USING CD 34 EXPRESSION IN RECTAL ADENOCARCINOMA TREATED BY ADJUVANT POSTOPERATIVE RADIOTHERAPY

Konference: 2008 33st Congress ESMO - účast ČR

Kategorie: Kolorektální karcinom

Téma: Colorectal cancer

Číslo abstraktu: 456

Autoři: Doc. MUDr. Josef Dvořák, Ph.D.; MUDr. Markéta Tomšová, Ph.D.; prof. MUDr. Bohuslav Melichar, Ph.D.; MUDr. Pavel Veselý, Ph.D.; MUDr. Věra Tyčová; MUDr. Milan Vošmik, Ph.D.; MUDr. Zdeněk Zoul, Ph.D.; prof. MUDr. Jiří Petera, Ph.D.

Purpose: To assess angiogenesis using CD 34 expression in locally advanced rectal adenocarcinoma treated by postoperative adjuvant radiotherapy.

Patients and methods: From 7/1996 to 3/2004, 56 patients (pts), 34 males and 22 females, median age 64 (36-80) years, with rectal adenocarcinoma were treated. Pathologic TNM stage was as follows: 36 (64%) pts stage II and 20 (36%) pts stage III. Thirty-nine pts were treated by radiochemotherapy and 17 pts by RT alone. Radiochemotherapy consisted of external beam RT 45-54 Gy in 25-30 fractions, 1.8 Gy daily, with concomittant 5-FU 200 mg/ m2 /day in continuous infusion. RT consisted of external beam RT 44-60 Gy in 22-30 fractions. In all pts was immunohistochemically assessed microvessel density (MVD) using CD 34 expression (mouse monoclonal anti-human CD 34, clone QBEnd10, DakoCytomation, diluted 1:50 was used). It comprised of 2 steps: firstly, foci with the highest density of capillaries ("hot spots") were identified in slides stained with antibodies against CD 34, under low magnification (10x objective lens). Secondly, the capillaries within the "hot spots" were quantified by higher magnification (20x objective lens). The highest number of capillaries and the mean number of capillaries was assessed. Survival curves (determined by Kaplan - Meier method) were compared by log-rank test.

Results: At the date of evaluation (February 29th, 2008) 30 pts were alive. The median of survival was 1885 days (95% C.L.: 1363-2142) days, 1-year survival 96% (95% C.L.: 92%-100%), 5-years survival 51% (95% C.L.: 36%-66%). Thirteen (23%)pts had recurrence: 4 pts local, 7 pts distant and 2 pts synchronously local and distant. The median of mean MVD was 104.6 (50.9-202.5) MV/mm2, the median of maximum MVD 112.1 (53.7-215.8) MV/mm2. The results of MVD were divided into 2 groups: £ 104.6 MV/mm2 (28 pts) and > 104.6 MV/mm2(28 pts). Survival curves for these 2 groups were not statistically different at the level 0.05.

Conclusions: The results of this pilot study demonstrate angiogenesis using CD 34 expression in locally advanced rectal adenocarcinoma treated by postoperative adjuvant radiotherapy.
Acknowledgement: Supported by the research project MZO 00179906.

Datum přednesení příspěvku: 12. 9. 2008