H Xu1, Y-J Ren, K Liu, X-L Min, L Yang, Y Zhou, J Zheng, C Yang. 1. Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China. yongjunrenad@163.com.
Abstract
OBJECTIVE: To investigate the correlations of serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) levels with colorectal liver metastasis (CLM) in patients with colorectal cancer (CRC), and determine the effects of transhepatic arterial chemoembolization (TACE) on their expressions. PATIENTS AND METHODS: A total of 110 CRC patients treated in the department of interventional radiology of our hospital from May 2013 to May 2016 were randomly enrolled. All patients received treatment of TACE after surgery. During surgery, 10 mL venous blood was taken, and the protein levels of VEGF and MMP-2 in serum were detected via enzyme-linked immunosorbent assay (ELISA). The correlations of VEGF and MMP-2 levels with clinicopathological features of patients were analyzed. The values of VEGF and MMP-2 in predicting CLM were analyzed using the receiver operating characteristic (ROC) curve. Moreover, changes in serum VEGF and MMP-2 levels in CRC patients were analyzed before TACE, and at 1 and 6 months after TACE. RESULTS: The median VEGF and MMP-2 levels in serum of CRC patients were 64.8 ng/mL and 114.4 ng/mL, respectively, which were significantly higher than those in healthy control group (5.3 ng/mL and 6.8 ng/mL) (p<0.05). The expressions of VEGF and MMP-2 in serum of CRC patients were correlated with the depth of tumor infiltration, Dukes' staging, CLM and lymph node metastasis (p<0.05). Logistic regression analyses showed that the expression levels of VEGF and MMP-2 were positively correlated with CLM (p<0.05). The ROC curve revealed that the sensitivity, specificity and accuracy of serum VEGF in the diagnosis of CLM were 62.2%, 78.5% and 80.2%, respectively. The sensitivity, specificity and accuracy of serum MMP-2 in the diagnosis of CLM were 68.9%, 85.5% and 82.2%, respectively. The serum VEGF levels in CRC patients before TACE, and at 1 and 6 months after TACE were (64.8±58.8) ng/mL, (43.1±27.3) ng/mL and (24.8±12.3) ng/mL, respectively, showing a downward trend (p<0.05). The serum MMP-2 levels in CRC patients before TACE, and at 1 and 6 months after TACE were (114.4±136.2) ng/mL, (73.4±58.5) ng/mL and (39.6±30.4) ng/mL, respectively, also indicating a reducing trend (p<0.05). CONCLUSIONS: The levels of VEGF and MMP-2 in portal vein serum of CRC patients can be used as effective indexes for judging the prognosis of CRC and predicting CLM. Patients with high expression of VEGF and MMP-2 should be actively treated with TACE after surgery to improve the survival rate.
OBJECTIVE: To investigate the correlations of serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) levels with colorectal liver metastasis (CLM) in patients with colorectal cancer (CRC), and determine the effects of transhepatic arterial chemoembolization (TACE) on their expressions. PATIENTS AND METHODS: A total of 110 CRCpatients treated in the department of interventional radiology of our hospital from May 2013 to May 2016 were randomly enrolled. All patients received treatment of TACE after surgery. During surgery, 10 mL venous blood was taken, and the protein levels of VEGF and MMP-2 in serum were detected via enzyme-linked immunosorbent assay (ELISA). The correlations of VEGF and MMP-2 levels with clinicopathological features of patients were analyzed. The values of VEGF and MMP-2 in predicting CLM were analyzed using the receiver operating characteristic (ROC) curve. Moreover, changes in serum VEGF and MMP-2 levels in CRCpatients were analyzed before TACE, and at 1 and 6 months after TACE. RESULTS: The median VEGF and MMP-2 levels in serum of CRCpatients were 64.8 ng/mL and 114.4 ng/mL, respectively, which were significantly higher than those in healthy control group (5.3 ng/mL and 6.8 ng/mL) (p<0.05). The expressions of VEGF and MMP-2 in serum of CRCpatients were correlated with the depth of tumor infiltration, Dukes' staging, CLM and lymph node metastasis (p<0.05). Logistic regression analyses showed that the expression levels of VEGF and MMP-2 were positively correlated with CLM (p<0.05). The ROC curve revealed that the sensitivity, specificity and accuracy of serum VEGF in the diagnosis of CLM were 62.2%, 78.5% and 80.2%, respectively. The sensitivity, specificity and accuracy of serum MMP-2 in the diagnosis of CLM were 68.9%, 85.5% and 82.2%, respectively. The serum VEGF levels in CRCpatients before TACE, and at 1 and 6 months after TACE were (64.8±58.8) ng/mL, (43.1±27.3) ng/mL and (24.8±12.3) ng/mL, respectively, showing a downward trend (p<0.05). The serum MMP-2 levels in CRCpatients before TACE, and at 1 and 6 months after TACE were (114.4±136.2) ng/mL, (73.4±58.5) ng/mL and (39.6±30.4) ng/mL, respectively, also indicating a reducing trend (p<0.05). CONCLUSIONS: The levels of VEGF and MMP-2 in portal vein serum of CRCpatients can be used as effective indexes for judging the prognosis of CRC and predicting CLM. Patients with high expression of VEGF and MMP-2 should be actively treated with TACE after surgery to improve the survival rate.