Serum vascular endothelial growth factor (VEGF) and metalloproteinase-7 (MMP7) as prognostic marker in patients with colorectal cancer and liver metastases

Background: Colorectal cancer (CRC) is one of the most frequent cause of cancer mortality in the European Union and the USA, with an overall 5-year survival accounting for less than 50%. In patients with CRC, the liver is a common site of metastases, which should be early detected and removed to improve survival. With the aim of revealing the presence of liver metastases (LMs), a number of serum tumor markers has been assayed, including carcinoembryonic antigen (CEA) and, more recently, metalloproteinase-7 (MMP7) and vascular endothelial growth factor (VEGF). The aim of this study was to evaluate the usefulness of preoperative MMP7 and VEGF serum levels measurement in predicting the onset of liver metastases (LMs) in patients with CRC. Patients and Methods: Eighteen patients (12 males, 6 females, median age 64 years, range 47-81) who underwent curative colorectal surgical resection for stage I-II CRC developed LMs during 1-2 years follow-up. Nineteen age-matched CRC patients at the same preoperative stage, in whom the presence of LMs have been excluded using 18F-FDG-PET/CT, were considered the control group. MMP7 and VEGF serum levels were preoperatively measured in all patients by automated homogeneous chemiluminescent immunoassay or manual heterogeneous enzyme-linked immunosorbent assay (ELISA), respectively. The cut-off values were 250 pg/mL and 7.5 ng/mL for MMP7 and for VEGF, respectively. Results: Nineteen age-matched CRC patients at the same preoperative stage, in whom the presence of LMs have been excluded using 18F-FDG-PET/CT, were considered the control group. MMP7 and VEGF serum levels were preoperatively measured in all patients by automated homogeneous chemiluminescent immunoassay or manual heterogeneous enzyme-linked immunosorbent assay (ELISA), respectively. The cut-off values were 250 pg/mL and 7.5 ng/mL for MMP7 and for VEGF, respectively. Conclusion: Preoperative serum measurements of both MMP7 and VEGR in patients with CRC are not useful in predicting LMs development, due to their low sensitivity, specificity and accuracy.