Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 670-686
Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.670
Expression and significance of pigment epithelium-derived factor and vascular endothelial growth factor in colorectal adenoma and cancer
Ye Yang, Wu Wen, Feng-Lin Chen, Ying-Jie Zhang, Xiao-Cong Liu, Xiao-Yan Yang, Shan-Shan Hu, Ye Jiang, Jing Yuan
Ye Yang, Digestive Diseases, Chengdu Qingbaijiang District People's Hospital, Chengdu 610300, Sichuan Province, China
Wu Wen, Ying-Jie Zhang, Xiao-Cong Liu, Xiao-Yan Yang, Shan-Shan Hu, Ye Jiang, Jing Yuan, Digestive Diseases, Chengdu Second People’s Hospital, Chengdu 610000, Sichuan Province, China
Feng-Lin Chen, Graduate School, Chengdu Medical College, Chengdu 610000, Sichuan Province, China
Author contributions: Wen W proposed and designed the project, provided scientific research funds, and coordinated and contacted various matters related to the pathology department; Zhang YJ, Liu XC and Yang XY collected the pathological specimens; Hu SS, Jiang Y and Yuan J performed the collection of patient data and summarized the experimental data; Yang Y did most of the experiments and wrote the first draft of the paper; Chen FL performed the statistical analysis of the data; all authors read, revised, and agreed to the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of the Second People's Hospital of Chengdu.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: The authors declare no competing interests.
Data sharing statement: The data that support the findings of this study are available on request from the corresponding author, upon reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wu Wen, Doctor, Chief Physician, Digestive Diseases, Chengdu Second People’s Hospital, No. 10 Qingyunan Street, Jinjiang District, Chengdu 610000, Sichuan Province, China. wenwu2@qq.com
Received: November 7, 2023
Peer-review started: November 7, 2023
First decision: December 31, 2023
Revised: January 16, 2024
Accepted: February 4, 2024
Article in press: February 4, 2024
Published online: March 15, 2024
ARTICLE HIGHLIGHTS
Research background

The morbidity and mortality of colorectal cancer (CRC) are among the highest in the world. When the balance between pigment epithelium-derived factor (PEDF), which inhibits angiogenesis, and vascular endothelial growth factor (VEGF), which stimulates angiogenesis, is broken, it can lead to uncontrolled angiogenesis and promote the occurrence of tumors. Therefore, it is necessary to find more therapeutic targets for early intervention and late treatment of CRC.

Research motivation

The safety and efficacy of targeted drugs targeting VEGF in the treatment of CRC have been confirmed and promoted. PEDF is the anti-VEGF factor. At present, no toxicity caused by PEDF preparation itself has been observed in anti-tumor vascular animal models. It is worth exploring the possibility of PEDF as a new target for early prevention and late treatment of CRC.

Research objectives

Study of the expression and significance of PEDF, VEGF, and CD31-stained microvessel density values (CD31-MVD) in normal colorectal mucosa, adenoma, and CRC.

Research methods

We collected 50 cases of normal intestinal mucosa, 50 cases of colorectal adenoma and 50 cases of colon cancer as normal control group, adenoma group and CRC group, respectively. Immunohistochemical staining was used to detect the expression of PEDF and VEGF in the three groups, and the differences were analyzed. The relationship between the expression of PEDF and VEGF and the clinicopathological factors of CRC was studied. CD31-MVD was recorded in the three groups, and the correlation between PEDF, VEGF and CD31-MVD in colorectal adenoma group and CRC group was analyzed.

Research results

The positive expression rate and expression intensity of PEDF in normal control group, adenoma group and CRC group gradually decreased, while that of VEGF gradually increased. In the CRC group, the positive expression rate of PEDF decreased with the increase of differentiation degree, invasion depth, lymph node metastasis, distant metastasis and TNM stage. The opposite was observed for VEGF high expression. In the colorectal adenoma group, the expression intensity of PEDF was negatively correlated with CD31-MVD, but there was no significant difference in VEGF expression. PEDF expression was negatively correlated with CD31-MVD and VEGF expression in CRC group. The expression of VEGF was positively correlated with CD31-MVD.

Research conclusions

It is possible that PEDF can be used as a new treatment and prevention target for CRC by upregulating the expression of PEDF while inhibiting the expression of VEGF.

Research perspectives

We will further expand our sample size to equalize the proportion of various types of adenomas in the colorectal adenoma group and the proportion of various pathological types of CRC in the CRC group to further confirm our conclusion.