ABSTRACT
PURPOSE: Angiogenesis and tumor invasion are complex processes that are mediated by various proteins, such as vascular endothelial growth factor (VEGF-α) and the matrix-degrading enzymes metalloproteinase-2 and -9 (MMP-2, MMP-9). The aim of this study was to determine what roles MMP-2, MMP-9, and VEGF-α play in colorectal cancer (CRC) by correlating their expression levels with the cancer TNM stage, modified Dukes criteria, degree of cell differentiation, and long-term patient survival. METHODS: The present series consisted of tissue samples obtained from 180 patients who had undergone large bowel resection during 1995 and 2005 at the Luis Antonio Hospital. Archival paraffin-embedded CRC tissue samples were used to generate tissue microarray blocks, which were immunohistochemically stained for MMP-2, MMP-9, and VEGF-α. Three different grading systems were applied to evaluate staining intensity. Chi-squared Person test and Kaplan-Meier survival curves were used, and values of p<0.05 were considered statistically significant. RESULTS: MMP-2 expression showed a significant association with more invasive cancer stages (p<0.001) and death (p<0.041). VEGF-α expression correlated with a high TNM stage (p<0.009), the degree of cell differentiation (p<0.025) and patient death as a result of disease (p<0.035). The Kaplan-Meier survival estimated that patients with strong staining for MMP-2 (log-rank x(2)=34.09; p<0.0001), MMP-9 (log-rank x(2)=12.83; p<0.0003) and VEGF (log-rank x(2)=33.9; p<0.0001) showed a greater tendency towards death during 60 months of follow up. CONCLUSIONS: The quantification of VEGF-α, MMP-2 and MMP-9 expression in colorectal cancer may be related to survival. These data add to the growing epidemiological and experimental evidence that VEGF-α, MMP-2 and MMP-9 may play a role in colorectal tumorigenesis.
Subject(s)
Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/pathology , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinase 9/metabolism , Neovascularization, Pathologic/diagnosis , Vascular Endothelial Growth Factor A/metabolism , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/metabolism , Colorectal Neoplasms/mortality , Female , Humans , Immunohistochemistry/methods , Male , Middle Aged , Neoplasm Staging/methods , Neovascularization, Pathologic/pathology , PrognosisABSTRACT
O presente trabalho apresenta os resultados da aplicaçäo do teste IMC, de Informaçäo, Memória e Concentraçäo, em uma amostra de idosos do Lar Torres de Melo em Fortaleza, Ceará. O teste foi adaptado de Hachinski de modo a atender as características sócio-econômicas e culturais da populaçäo testada. Dos 71 pacientes examinados, 37 ou 52,1% foram considerados como dementes pelo exame neurológico. Estas cifras näo indicam risco nem tampouco prevalência, em virtude de se tratar de amostra näo aleatória, em populaçäo de idosos internados. Com a aplicaçäo do IMC-modificado, objetiva-se dispor de um instrumento dotado de razoável sensibilidade-especificidade e que poderá ser útil como método auxiliar na detecçäo de demência em grupos específicos
Subject(s)
Aged , Humans , Dementia/diagnosis , Memory , Neurologic ExaminationABSTRACT
O presente trabalho apresenta os resultados da aplicacao do teste IMC, de Informacao, Memoria e Concentracao, em uma amostra de idosos da Lar Torres de Melo em Fortaleza, Ceara. O teste foi adaptado de Hachinski de modo a atender as caracteristicas socio-economico e culturais da populacao testada. Dos 71 pacientes examinados, 37 ou 52,1 por cento foram considerados como dementes pelo exame neurologico. Estas cifras nao indicam risco nem tampouco prevalencia, em virtude de se tratar de amostra nao aleatoria, em populacao de idoso internados. Com a aplicacao do IMC-modificado, objetiva-se dispor de um instrumento dotado de razoavel sensibilidade-especificidade e que podera ser util como metodo auxiliar na deteccao de demencia em grupos especificos.
