الفهرس 
review of literatureOnly 14 pages are availabe for public view
 |  | from | 127 |  |  |
| | | from | 127 | | |
Abstract
Colorectal carcinoma (CRC) is considered the second commonest cause of cancer worldwide. It accounts for 783,000 new cases per year (9.7% of all cancer cases worldwide), and 437,000 cases of death (8.4%). CRC ranks third in frequency in men and women.
Angiogenesis, the process of new blood vessel formation, is an essential step in tumor growth and metastasis. Generally, tumors cannot beyond 1-2mm in diameter without the development of vascular supply. The process of angiogenesis is regulated by a delicate balance between local pro-angiogenic and anti-angiogenic factors, which are released by both tumor and host cells including endothelial cells pericytes and immune system cells. Thus, vascular endothelial growth factors (VEGF) and its receptors play a pivotal role in normal and pathologic angiogenesis. Over expression of VEGF is associated with poor prognosis and reduced overall survival in a wide variety of human cancers.
Tumor markers are substances developed in or induced by many cells of the body in response to certain benign or cancer conditions. Proliferative processes, such as inflammatory and benign transformations, are able to induce the rise of tumor marker levels. Also, the malignant transformation of cells leads to increased concentrations of tumor markers and thus they can indicate malignant diseases. Some of them are seen only in a single type of the cancer, while others can be detected in several types of cancers. Accordingly, neither tumor markers specificity are enough to diagnose a specific type of cancer nor, their sensitivity enough to screen for CRC. The most important use of tumor makers is to monitor patients being treated for cancer, especially advanced cancer. Tumor marker levels and sensitivity increased with increasing Dukes’ stage of disease. Pretreatment elevated tumor markers correlates with poorer prognosis and increased tumor recurrence are following treatment.
Carcinoembryonic antigen (CEA) and carcinogenic antigen 19.9 (CA19.9) are frequently used in daily practice because of their relative specificities and usefulness to the common cancers. CEA is expressed in normal mucosal cells and over-expressed in adenocarcinoma, especially colorectal cancer.CA19.9 occur primarily in patients with pancreatic and biliary tract cancers, but also have been reported in patients with other malignancies.
This study was carried on 78 subjects; 68 patients (histologically confirmed for colorectal carcinoma, subjected to elective surgery at Mansoura University Hospitals, Mansoura University): 39 males and 29 females with ages ranged from 24-74 years and healthy individuals (6 males and 4 females) of matched age and sex.
These patients were subjected to clinical, endoscopic, radiological, histopthological evaluation. Routine investigations including, serum bilirubin, ALT, AST, Creatinine, CEA, CA19.9. CBC and specific investigations in form of study of VEGF expression for both patients and controls.
This study showed an increase in CEA, CA19.9 and VEGF levels in CRC patients when compared with control subjects and showed a significant correlation between CEA and VEGF serum levels (p<0.05). Also there was an increase in serum CEA, CA19.9 and VEGF levels of patients with L.N metastasis versus patients without L.N metastasis.