Rajaganeshan R et al. - In a study to determine the role of hypoxia in predicting pts who are at high risk of disease recurrence in Dukes B colorectal cancers (CRC), results suggest an important role for Hif-1α and VEGF in CRC progression, with both markers' biological mechanisms directly interlinked through the hypoxic pathway. Identification of high-risk pts using the above factors will improve treatment strategies in node-negative disease and help improve pt outcome Methods
Archival tissue was retrieved from 52 pts who had undergone surgical resection for primary CRC
Tissue micro-arrays were constructed using tissue from the margin and the centre of the tumour
Hypoxia markers hypoxia-inducible factor (Hif)-1α, vascular endothelial growth factor (VEGF), carbonic anhydrase (CA)-9, and glucose transporter (Glut)-1 were visualised using immunohistochemical detection and quantified using semi-quantitative analysis of the digitised images
Clinical details and outcome data were retrieved by case note review and collated with hypoxia markers data in a statistical database
Results
Primary CRCs with a high Hif-1α expression tended to have a significantly worse disease-free survival and overall survival
VEGF was also a significant predictor of disease recurrence in primary CRCs
Significant correlations were also noted between Hif-1α and VEGF
Glut-1 and CA-9 did not show a similar pattern with no differences in the expression pattern and no correlation observed with any of the markers
Multivariate analysis of prognostic factors showed vascular invasion and Hif-1α at tumour margin to be independent predictors for the development of liver metastases
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