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Category: Volume 06 Issue 08 August 2018
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Title: Role of Molecular Markers (P53, EGFR AND VEGF) in Prognostication of Carcinoma Rectum

Authors: Ganesh Chandra Yadav, Arshad Ahmad, Abhishek Kumar, Abhinav Arun Sonkar, Suresh Kumar, Vijay Kumar

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.02

Abstract

Colorectal cancer is the third most common cancer worldwide. Surgery remains the primary determinant of cure in patients with localized rectal cancer and for patients with invasive tumors neo-adjuvant chemoradiotherapy has been utilized to promote tumor regression. EGFR, VEGF and p53 are among the markers currently of interest as potential predictors of pathologic response, prognosis and recurrence-free survival in rectal cancer. In this study we assess the prognostic value of p53, VEGF and EGFR and predictive value of these molecular markers in assessing the overall outcome in cases of carcinoma rectum. Biopsy proven patients of carcinoma rectum (stage I to stage IV) were included in the study. Patients were treated according to standard protocols. Patients were followed for response to CRT, disease free survival and overall outcome. Our study shows over expression of p53, VEGF and EGFR are associated with poor response from CRT, poor outcome and short survival in carcinoma rectum. These findings were statistically significant for VEGF and EGFR (not significant for p53).We conclude that study with larger sample size and longer follow up may establish these markers as independent predictor of overall outcome in patient of carcinoma rectum.

Keywords: Epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), p53, colorectal cancer (CRC) and chemoradiotherapy (CRT).

References

  1. World Cancer Research Fund and American Institute for Cancer Research Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. Washington, DC: American Institute for Cancer Research; 2007.
  2. Center MM, Jemal A, Smith RA, Ward E. Worldwide variations in colorectal cancer.CA Cancer J Clin. 2009;59:366–78. [PubMed: 19897840]
  3. Center MM, Jemal A, Ward E. International trends in colorectal cancer incidence rates. Cancer Epidemiol Biomar-kers Prev.2009;18:1688–94. [PubMed: 19505900]
  4. Virk R, Gill S, Yoshida E, Radley S, Salh B. Racial differences in the incidence of colorectal cancer.Can J Gastroenterol. 2010;2:47–51. [PMCID: PMC2830637][PubMed: 20186356]
  5. Three-years report of Population Based Cancer Registries 2006-2008 (Detailed Tabulations of Individual Registries Data). National Cancer Registry Programme (Indian Council of Medical Research), Bangalore November. 2010. [accessed on December 27, 2012]. Available from:http://www.PBCR_2006_2008.aspx
  6. Nath J, Wigley C, Keighley MR, Perakath B. Rectal cancer in young adults: a series of 102 patients at a tertiary care centre in India.Colorectal Dis. 2009;11:475–9.
  7. Koukourakis GV, Role of radiation therapy in neoadjuvant era in patients with locally advanced rectal cancer,world J Gastrointest Oncol 2012 Dec 15;4(12): 230-7.
  8. Nozue M, Isaka N, Fukao K. Over-expression of vascular endothelial growth factor after preoperative radiation therapy for rectal cancer. Oncol Rep 2001;8:1247–9.
  9. Zlobec I, Vuong T, Compton CC, Lugli A, Michel RP, Hayashi S, Jass JR. Combined analysis of VEGF and EGFR predicts complete tumour response in rectal cancer treated with preoperative radiotherapy. Br J Cancer.2008 Jan 29;98(2): 450-6.
  10. Luderer LA, Lustosa SAS, Silva SEM, Denadai MVA, Afonso Jr RJ, et al. (2015) Significance of a Biomarkers Immunohistochemistry Panel for Survival Prognostic in Patients with Sporadic Colorectal Cancer. Ann Clin Pathol 3(2): 1050.
  11. Z S Zeng, A S Sarkis, Z F Zhang, D S Klimstra, E Charytonowicz, J G Guillem, C Cordon-Cardoand A M Cohen: p53 nuclear overexpression: an independent predictor of survival in lymph node--positive colorectal cancer patients.
  12. Rebischung C, Gérard JP, Gayet J,  Thomas G, Hamelin R, Laurent-Puig P. Prognostic value of P53 mutations in rectal carcinoma.Int J Cancer.2002 Jul 10;100(2):131-5S
  13. Ruud Wiggenraad., Reinder Tamminga, Paul Blok., Remigio Rouse.The Prognostic Significance of P53 Expression for Survival and Local Control in Rectal Carcinoma Treated with Surgery and Postoperative Radiotherapy. International Journal of Radiation Oncology. 1998;41:29-35
  14. Scott,A. Hale , M. Deakin , P. Hand,  F.A. Adab, C. Hall , G.T. Williams , J.B. Elder: A histopathological assessment of the response of rectal adenocarcinoma to combination chemo-radiotherapy: relationship to apoptotic activity, p53 and bcl-2 expression
  15. S Cascinu, F Graziano, V Catalano, M P StaccioliAn analysis of p53, BAX and vascular endothelial growth factor expression in node-positive rectal cancer. Relationships with tumour recurrence and event-free survival of patients treated with adjuvant chemoradiationBr J Cancer.2002 Mar 4;86(5):744-9.
  16. Yibaina Wang, Xiaoping Yao, Jie Ge, Fulan Hu and Yashuang Zhao et al: Can Vascular Endothelial Growth Factor and Microvessel Density Be Used as prognostic Biomarkers for Colorectal Cancer? A systematic Review and Meta- Analysis. Sci W Jor Volume 2014.
  17. Giralt J, Navalpotro B, Hermosilla E, et al. Prognostic significance of vascular endothelial growth factor and cyclooxygenase-2 in patients with rectal cancer treated with preoperative radiotherapy. Oncology 2007;71:312–9.

Corresponding Author

Dr Arshad Ahmad

Associate Professor, Department of Surgery, King George’s Medical University, Lucknow, India-226003

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