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Plasma levels of angiostatin and endostatin remain unchanged for the first 3 weeks after colorectal cancer surgery

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Abstract

Introduction

Angiostatin and endostatin are endogenous inhibitors of angiogenesis with anticancer effects. After minimally invasive colorectal resection (MICR), blood levels of the proangiogenic factors vascular endothelial growth factor (VEGF) and angiopoetin 2 (Ang-2) are elevated for 2–4 weeks. Also, postoperative human plasma from weeks 2 and 3 after MICR has been shown to stimulate endothelial cell proliferation and migration, which are critical to angiogenesis. This proangiogenic state may stimulate tumor growth early after MICR. Surgery’s impact on angiostatin and endostatin is unknown. This study’s purpose is to determine perioperative plasma levels of these two proteins in colorectal cancer (CRC) patients undergoing MICR.

Methods

Endostatin levels were assessed in 34 CRC patients and angiostatin levels in 30 CRC patients. Blood samples were taken preoperatively and on postoperative day (POD) 1 and 3 in all patients; in a subset, samples were taken between POD 7 and 20. The late samples were bundled into 7-day blocks (POD 7–13, POD 14–20) and considered as single time points. Angiostatin and endostatin plasma levels were determined via enzyme-linked immunosorbent assay (ELISA) in duplicate. Wilcoxon signed-rank test and Student’s t test were used to analyze endostatin and angiostatin data, respectively. Significance was set at P < 0.0125 (after Bonferroni correction).

Results

There was a significant decrease in median plasma endostatin levels on POD 1, which returned to the preoperative level by POD 3. There was no significant difference between pre- and postoperative plasma angiostatin levels.

Conclusions

MICR has a very transient impact on plasma levels of endostatin and no impact on angiostatin during the first 21 days following surgery. Thus, angiostatin and endostatin do not likely contribute to or inhibit the persistent proangiogenic changes noted after MICR.

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Disclosures

HMC Shantha Kumara, Samer T Tohme, Xiaohong Yan, Abu Nasar, Anthony J Senagore, Matthew F Kalady, Neil Hyman, Ik Y Kim, and Richard L Whelan have no conflicts of interest or financial ties to disclosure.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, St. Luke-Roosevelt Hospital Center, Suite 7B, 425 West, 59th Street, New York, NY, 10019, USA

    H. M. C. Shantha Kumara, Samer T. Tohme, Xiaohong Yan, Abu Nasar & Ik Y. Kim

  2. Spectrum Health, 25, Michigan Ave SE, Suite 4300, MC 038, Grand Rapids, MI, 49503, USA

    Anthony J. Senagore

  3. Department of Colorectal Surgery, Digestive Disease Institute, 9500, Euclid Avenue, A 30, Cleveland, OH, 44195, USA

    Matthew F. Kalady

  4. Department of Surgery, Fletcher 465, University of Vermont, College of Medicine, Burlington, VT, 05401, USA

    Neil Hyman

  5. Section of Colon and Rectal Surgery, Department of Surgery, St. Luke-Roosevelt Hospital Center, Suite 7B, 425 West, 59th Street, New York, NY, 10019, USA

    Richard L. Whelan

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  1. H. M. C. Shantha Kumara
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Correspondence to Richard L. Whelan.

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Shantha Kumara, H.M.C., Tohme, S.T., Yan, X. et al. Plasma levels of angiostatin and endostatin remain unchanged for the first 3 weeks after colorectal cancer surgery. Surg Endosc 25, 1939–1944 (2011). https://doi.org/10.1007/s00464-010-1491-2

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  • DOI: https://doi.org/10.1007/s00464-010-1491-2

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