Case report and the profiles of the vascular endothelial growth factor protein family and its receptors in Taiwan colorectal cancer

• Main Authors: Chien-Chih Yeh, 葉建志
• Other Authors: Yung-Hsi Kao
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/248ue7

博士 === 國立中央大學 === 生命科學系 === 106 === Colorectal cancer (CRC) is a cancer that starts in the colon or rectum. 1.4 million new cases were diagnosed with CRC over the world in 2012 and more than 50 percent of CRC cases occurred in more developed countries. According to the WHO statistics, about 774,000 people died from the CRC in 2015, and this disease is the third most common cause of death worldwide, including Taiwan. In 2015 in Taiwan, 24.2 in 100,000 people (27.4 in 100,000 men and 21.0 in 100,000 women) died from the CRC. This reflects the big impacts of CRC on a country mortality and human health. The overall objective of this dissertation was thus to report new cases in CRC patients living in Taiwan, as well as evaluating the profiles of the vascular endothelial growth factor (VEGF) family and the VEGF receptors (VEGFR) in patients with CRC. The first chapter indicated a new CRC case on synchronous triple carcinoma of the colon and rectum from a case of a 79-year-old patient who did not have a family history of cancer but had a 3-month history of abdominal pain associated with anemia, loss of appetite, and body weight loss. This was the first case of synchronous triple carcinoma of the colon and rectum found in Taiwan. The second chapter showed a new CRC case on synchronous mucinous cystadenoma of the appendix (characterized by a cystic dilatation of the appendicular lumen with stasis of mucus inside it) in an 82-year-old patient who had several weeks’ history of low abdominal pain associated with anemia. The third chapter showed synchronous changes in tissue and circulating protein levels of all the five VEGFs and all the three VEGFRs from Taiwan patients with colorectal carcinoma. VEGF-A, -B, -C, -D, placental growth factor (PlGF), VEGFR-1, VEGFR-2 and VEGFR-3 were higher in tumor tissues than non-tumor tissues. Besides having higher circulating VEGFs and soluble VEGFRs than healthy subjects, metastatic patients exhibited higher VEGF-A, -B, -C, -D and PlGF proteins in both tumor tissue and serum than non-metastatic patients. Besides serum VEGFs, VEGF-positive or VEGFR-positive cases were mainly associated with the age, tumor site, tumor size, tumor stage and lymph node metastasis. Positive correlations between VEGF and VEGFR reflected their specific relationship. Patients exhibiting high levels of VEGF and VEGFR had a shorter overall survival and a less disease-free survival than those with low levels. These data suggest that particular VEGF and VEGFR family members allow discrimination of metastatic CRC from non-metastatic CRC in the studied Taiwanese population and may be possibly used as a marker for gauging the clinical effect of various treatment on the CRC patients.