Low EGFL7 expression is associated with high lymph node spread and invasion of lymphatic vessels in colorectal cancer.

Studies indicate EGFL7 as an important gene in controlling angiogenesis and cancer growth, including in colorectal cancer (CRC). Anti-EGFL7 agents are being explored, yet without promising results. Therefore, the role of EGFL7 in CRC carcinogenesis should be investigated. This study aimed to evaluate the prognostic value of EGFL7 expression in CRC and the signaling pathways influenced by this gene. EGFL7 expression was evaluated through immunohistochemistry in 463 patients diagnosed with CRC and further associated with clinicopathological data, angiogenesis markers and survival. In silico analyzes were performed with colon adenocarcinoma data from The Cancer Genome Atlas. Analysis of enriched gene ontology and pathways were performed using the differentially expressed genes. 77.7% of patients presented low EGFL7 expression, which was associated with higher lymph node spread and invasion of lymphatic vessels, with no impact on survival. Additionally, low EGFL7 expression was associated with high VEGFR2 expression. Finally, we found in silico that EGFL7 expression was associated with cell growth, angiogenesis, and important pathways such as VEGF, Rap-1, MAPK and PI3K/Akt. Expression of EGFL7 in tumor cells may be associated with important pathways that can alter functions related to tumor invasive processes, preventing recurrence and metastatic process.

Cervical Cancer Posttreatment Follow-up: Critical Analysis.

OBJECTIVE: The aim of this study was to evaluate the role of follow-up tests and examinations in diagnosing symptomatic and asymptomatic relapses after treatment for cervical cancer. METHODS: Data were collected from medical records for all patients diagnosed as having cervical cancer from January 1985 to June 2010. The significance level was P < 0.005. RESULTS: Sixty-four (17.8%) of the 358 patients investigated suffered tumor relapse. Thirty-four (53.1%) were symptomatic, and 30 (46.9%) were asymptomatic. Most patients had tumor relapse diagnosed during physical examination, both among the symptomatic patients (50%) and the asymptomatic patients (66.7%) (P = 0.27). Cytopathology was responsible for detecting relapse in only 1 case in each group, corresponding to 2.9% and 3.3%, respectively (P = 0.99). Imaging examinations confirmed 10 relapses (29.4%) among symptomatic patients and 8 cases (26.6%) among asymptomatic patients (P = 0.77). There were no statistically significant differences between the 2 groups or between the different methods of detecting relapses. There was still no association after adjustment for potential confounding factors such as age and type of treatment. CONCLUSIONS: Physical examination was the preeminent method for detecting tumor relapse in this study. None of the other tests or examinations were capable of detecting relapses in both symptomatic and asymptomatic patients. These results highlight the urgent need for prospective studies that compare the efficacy of different follow-up regimens, analyzing factors such as global survival, quality of life, and cost.