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Angiogenesis as Predictor of Survival in Carcinomas r Correlation Coefficient Study

Contact Person: Alberto G Pizarro (rediegal@homonet.com.mx)


The angiogenesis is a process morphogenetic fundamental in the one which are generated new capillary as of already existing blood vessels (1,2,3,4) For this, the vascular endotelial cells must invade the fabric that surrounds them and proliferate in the apex of the new capillary. Both processes, invasion and proliferation, are repeated sequentially until the new capillary net remains thoroughly established. On the other hand, they exist many dependent pathologies of angiogenesis. Such is the case of the rheumatic arthritis, diabetical retinopaty, psoriasis, barthonelosis, transplanted organs rejection, hemorrhages and visual angiogenesis(one of the cases most frequent of blindness)(1,2,3,4,8,12). The angiogenesis, furthermore, it plays an important paper in the progressive growth and metastasic invasion of the tumors (5,6,7,9,10,14). A tumor must stimulate continually the development of new capillary for power to grow. Also, the new vessels localizated in the tumor provide to the malicious cells a route by where they can enter the traffic and to establish metastasis in distant places. (4,6,9,11,13,14)

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Materials and Methods

To determine the angiogenesis and the survival time of the patients with carcinoma were accomplished the following steps:

1.To identify a cohort that is reúne in the past. 1.To collect data on the study variables. (measures in the present)

2.To effect a follow-up of the cohort.

3.To collect data on the conclusion variables: survival or death time. (measures in the past or present)

They were checked slides of the pathology service with diagnostic of carcinoma in the time lapse of the 1 of January of 1992 to the 31 of December of 1996 in the Hospital Issste "Dr Aquiles Calles" of Tepic Nayarit Mexico.

In the histhologic slides was registered the number of new vessels in 3 fields of 100 x. Already it detected each patient was continued your clinic evolution and their survival time until their death or until 31 of December of 1996. The survival was quantified as person - month .El survival time starts in the date of the diagnostic histopatológico. The survival was investigated in the clinical records and death certificates. The patients that they did not had slides neither time of survival were excluded of the study. All variables were captured in a questionnaire.


All the registered data were processed in the package EPIINFO version 5.0 and in Excel97.


It is a finite population without replacement. Ours calculation was 34 cases. We studied all the population of study.

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We studied 85 patient with 59 women and 26 men with ages of 31 to 97 years (range) with mean of 60.3 years. The histopathologic diagnosis of the carcinomas was: epidermoid Carcinoma 44 cases, Adenocarcinoma 34 cases and indifferenciated Carcinoma in 7 casos.No there were meaningful differences among the age,sex,and histhologic diagnosis with the variables of study.

It was accomplished a r correlation study with dispersion graph of the variables of angiogensis and time of survival. We find a coefficient r of - 0.55 with r² of 0.30 something which demonstrates us that the correlation is moderated, strong and negative that indicates that to greater score of angiogenesis smaller survival time. This correlation demonstrates that alone acts in 30% of the total of the time of survival of the patients with cancer

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Discussion and Conclusion

The results of this epidemiological cohorts study indicate that the correlation r coefficient among the number of angiogenesis of the carcinomas and their time of survival was of - 0.55 that it is of moderate power and negative with a p = < 0.01

The study was unilateral of a tail with a on the up and up coefficient of 95% and a alfa of 0.05 therefore their your value is of greater effect.

This result can be a very important factor to implement oncological therapeutic but aggressive in early stages of the cancer.

The symptomatology was not for us a good measurement element for the beginning of the survival time, since of 85 patient studied 20 of they were not counting in their records on that datum. Some of they was found asymptomatics. We begin the time of survival from the date of the histopathologic diagnostic and we end it in 31 of December of 1996 in the live and before in the dead. This one must take into account, to the moment of accomplishing comparisons.

There were 15 cases that lost their medical licence but continued in the study.

The confusion variables were treated in statistics by the stratification method and they did not influence the results.

It was studied all the population and with them were avoided various biases.

Though the time of survival of our study we encompasses as maxim to 4 years, are needed of 3-6 years but of follow-up for conclusions but exact and complete.

Would be useful that the oncologics took into account this value predictive to easy obtainment in their next therapeutic measures.

The values of score less than 40 in the angiogénesis do not have a value meaningful forecast unless the patient has a carcinoma in situ or borderline. But values up above of 50 has a value overcoat forecast in patient with invading carcinoma or metastasic, since their survival reduces significantly to less of 1 year in most of the patients.


It was demonstrated that to greater score of angiogenesis there is smaller survival time.

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1.-Folkman and Shing, AngiogenesisJ. Biol. Chem., 267:10931 (1992).

2.-Hanaham and Folkman,Angiogenes. Cell, 86: 353 (1996).

3.-Strickland and G. Richards, Angiogenesis Cell, 71: 355 (1992).

4. Gasparini G. Quantification of intratumoral vascularisation predicts metastasis in human invasive solid tumours. Oncol Rep. 1, 7-12, 1994 (review).

5. Folkman J. What is the evidence that tumors plough angiogenesis - depends? J Natl Cancer Inst. 82, 4-6, 1990 (commentary).

6. Weidner N, Semple JP, Welch WR, Folkman J. Tumor angiogenesis and metastasis - - correlation in invasive breast carcinoma. New England Journal of Medicine. January 3,1991; volume 324, number 1, you pay 1-8.

7. - Folkman J, Watson K, Ingber D, Hanahan D. Induction of angiogenesis during the transition from hyperplasia to neoplasia. Nature 339, 58-61, 1989.

8. Guinebretiere JM, To him/her/you Monique G, Gavoille To et to the. Angiogenesis and risk of breast cancer in women with fibrocystic disease. J Natl Cancer Inst 86, 635-636, 1994 (letter).

9.-Harris TO THE; Zhang H; Moghaddam To; Fox S; Scott P; Pattison To; Gatter K; Stratford I; Bicknell R: Angiogenesis; Breast Cancer Beast Treat; 38(1):97-108 1996

10.-Leek RD, Harris TO THE, Lewis CE. Cytokine networks in solid human tumors: regulation of angiogenesis. J Leukoc Biol 1994;56(4):423-35.

11. - Horak ER, Leek R, Klenk N, LeJeune S, Smith K, Stuart N, Greenall M, Stepniewska K, Harris TO THE. Angiogenesis, assessed by platelet/endothelial cell adhesion molecule antibodies, ace indicator of node metastases and survival in breast cancer. Lancet 1992;340(8828):1120-6.

12. - Hollingsworth HC; Kohn EC; Steinberg SM; Rothenberg ML; Merino MJ Angionesis Am J Pathol, 147: 1, 1995 Jul, 33-41

13.-Leek RD, Lewis CE, Whitehouse R, Greenall M, Clarke J, Harris TO THE. Association of macrophage infiltration with angiogenesis and prognosis in invasive breast - carcinoma. Cancer Beast 1996;56(20):4625-462.

14. Gasparini G, Harris TO THE. Clinical importance of the determination of tumor angiogenesis in breast carcinoma: much dwell than to new prognostic tool. J Clin Oncol. 13, 765-782, 1995 (Review).

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Pizarro, A; Díaz, R; (1998). Angiogenesis as Predictor of Survival in Carcinomas r Correlation Coefficient Study. Presented at INABIS '98 - 5th Internet World Congress on Biomedical Sciences at McMaster University, Canada, Dec 7-16th. Available at URL http://www.mcmaster.ca/inabis98/cancer/pizarro0121/index.html
© 1998 Author(s) Hold Copyright