Correlation criteria between extramural invasion of blood vessels and immunohistochemical markers in the processes of neovasculogenesis

Abstract

Establishing the treatment strategy for patients diagnosed with colorectal cancer is based on their imaging and immunohistochemical evaluation. Depending on the stage of tumor invasion and its aggressiveness, is individualized, surgical, oncological, or both treatment. The most important factor for establishing these protocols is the impact of the tumor on intra- and perilesional colorectal vasculature and implicitly on the process of vascular neoformation in the paraneoplastic syndrome. In this regard, we studied a group of patients, colonoscopically diagnosed with colorectal cancer. The study method was to compare the expression of CD34 tumor marker with EMVI (extramural vascular invasion) staging criteria. The results of our study were compared with the intraoperative aspects. In all cases studied tumor extension reached to at least intestinal muscle layer. We conclude that expression of the CD34 marker has always been increased in correlation with EMVI 3-4 stages. In 2 patients with EMVI score 2, the immunohistochemical marker expression was 6% above the maximum threshold. The expression of vascular endothelial proliferation marker is closely correlated with the EMVI score - these values increase proportionally. The use of both criteria for establishing neovasculogenesis, significantly increases the predictability of postoperative progression and long-term survival.