Immunohistochemical evaluation of vascular endothelial growth factor (VEGF) in colorectal carcinoma

BACKGROUND: Vascular endothelial growth factor (VEGF) is one of the most important proangiogenic factors over-expressed in many human cancers and is usually associated with an unfavorable outcome. This work was planned to assess VEGF and microvessel density (MVD) in colorectal carcinoma (CRC) and to correlate them with the available clinicopathological parameters. MATERIAL AND METHODS: Ten normal colonic mucosa, 21 adenoma and 70 CRC cases were examined by immunohistochemical staining using anti-VEGF antibody. RESULTS: Eighty-one percent (81%) of adenoma and 78.6% of CRC cases showed VEGF immunoreactivity; however, the intensity of staining was significantly in favour of malignant cases (p=0.032). VEGF immunostaining in CRC was correlated with low grade (p=0.009), early stage either by Dukes' system (p=0.03) or TNM stage (p=0.03), negative nodal status (p=0.04) and high mast cell count (p=0.04). MVD assessed by Haematoxylin and Eosin staining was associated with dense inflammatory response (p=0.003) and high mast cell count (p=0.006). CONCLUSIONS: VEGF could be an early carcinogenic factor in CRC that declines with its progression. Inflammatory cells including mast cells could play a role in CRC angiogenesis.