Expression and prognostic significance of angiopoietin in colorectal carcinoma

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Abstract
Background and Objectives Growth and metastasis of malignant tumors depend on the angiogenesis. The aim of this study was to elucidate the prognostic significance of angiopoietin‐1 (Ang‐1) and angiopoietin‐2 (Ang‐2) expression in advanced colorectal carcinoma. Methods Totally, 101 patients with surgically resected advanced colorectal carcinomas were enrolled. The tumor expressions of Ang‐1 and Ang‐2 were evaluated immunohistochemically, and their relationships with clinicopathological factors and prognosis were investigated. Tumor microvessel density (MVD) was also calculated and correlated with angiopoietin expression. Results Ang‐1 and Ang‐2 were detected in 26 (25.7%) and 45 (44.6%), respectively, of 101 cancerous lesions. Overexpression of Ang‐1 was correlated with high MVD. Overexpression of Ang‐2 was correlated with lymph node metastasis, venous invasion, preoperative carcinoembryonic antigen levels, and high MVD (P ≤ 0.05). MVD was not significantly upregulated by Ang‐1 expression, but was significantly upregulated by Ang‐2 expression (P ≤ 0.01). However, only patients with Ang‐2 overexpression showed a significantly worse prognosis than those without Ang‐2 overexpression. Multivariate analysis with logistic regression for 5‐year survival revealed that cancerous stage and Ang‐2 overexpression were independent prognostic indicators. Conclusions The Ang‐1 expression correlated with MVD. However, Ang‐2 expression was a useful prognostic marker in the management of patients with advanced colorectal carcinoma. J. Surg. Oncol. 2006;94:631–638.