COMPUTERIZED QUANTIFICATION OF INTRA-TUMORAL VASCULARIZATION AND PROLIFERATION OF COLORECTAL CARCINOMA: A MORPHOMETRIC INVESTIGATION
DOI:
https://doi.org/10.11603/mie.1996-1960.2022.3.13372Keywords:
colorectal cancer, tumor vascularization, digital pathology, CD-34, Ki-67Abstract
Background. Colorectal cancer (CRC) is considered a marker of socio-economic development, due to the fact that in countries experiencing a transition period in the economy, the incidence rate of CRC has a tendency to increase uniformly. Lifestyle changes have increased the incidence of CRC in recent decades, namely, a diet with increased consumption of animal products and a more sedentary lifestyle leads to a decrease in physical activity and an increase in the prevalence of excess body weight (metabolic syndrome), which also becomes increasingly urgent problem for Ukraine. Intratumoral vascularization and proliferation are considered by many researchers as an independent prognostic factor during cancer. One of the practical ways of observing angiogenesis is the study of histological sections of tumors, where the endothelium of vessels is distinguished by immunohistochemical staining with markers CD31 or CD34. The aim of the study was to evaluate intratumoral vascularization and cell proliferation in colorectal carcinomas using the Fiji platform.
Material and methods. The work examined the clinical and anatomical material of CRC of 37 patients (15 women and 22 men), which was obtained during operations (right hemicolectomy, resection of the sigmoid colon, Hartmann's operation, resection of the transverse colon, resection of the ileum); all of them were treated in the 2nd surgical department of the Dnipropetrovsk Regional Clinical Hospital in the period from 2019 to 2021. The age of the patients ranged from 27 to 82 years; the average age was 61.43±14.90 years.
Results. The average number of CD-34-positive vessels showed a significant difference in age groups (with increasing age, the number of vessels increased, p<0.05); by histological type (the smallest number of vessels was found in adenocarcinoma of the adenoma-like type, the largest in micropapillary adenocarcinoma, p<0.05); by grade (in group G2, the
number of vessels was significantly higher, p<0.05); and also in the group with metastases, the number of vessels was significantly higher compared to the group without metastases, p<0.05.
The average area of CD-34-positive vessels showed a significant difference in age groups (with increasing age, the area of vessels increased, p<0.05); by histological type (the smallest area of vessels was found in adenocarcinoma of the adenoma-like type, the largest in medullary adenocarcinoma, p<0.05); and also, in the group with G3, the area of blood vessels was significantly larger (p<0.05).
Conclusions. The average perimeter of CD-34-positive vessels showed a significant difference only by histological type (the smallest perimeter of vessels was found in adenocarcinoma of the adenoma-like type, the largest in micropapillary adenocarcinoma, p<0.05).
The proliferation index increased along with the average number and average area of CD-34-positive vessels (all p<0.05).
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