Prospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2023; 15(9): 2052-2062
Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.2052
Quantitative evaluation of colorectal tumour vasculature using contrast-enhanced ultrasound: Correlation with angiogenesis and prognostic significance
Ming-Hui Li, Wei-Wei Li, Ling He, Jian-Fang Li, Sun-Yan Zhang
Ming-Hui Li, Wei-Wei Li, Ling He, Department of Ultrasound, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Regions, China
Jian-Fang Li, Department of Medical Imaging, Baoding Maternal and Child Health Hospital, Baoding 071023, Hebei Province, China
Sun-Yan Zhang, Department of Ultrasonography, Nantong Haimen District People’s Hospital, Nantong 226100, Jiangsu Province, China
Author contributions: Li MH and Li JF designed and coordinated this study; Li WW and He L conducted experiments to obtain and analyze data; Zhang SY, Li MH, Li WW, and Zhang SY explained the data; Li JF, He L, Li WW, Li MH, and Zhang SY wrote the manuscript; and all authors have approved the final version of this article.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board at Tumor Hospital Affiliated to Xinjiang Medical University.
Clinical trial registration statement: The research registration number is 8823.
Informed consent statement: All participants provided written informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
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: Sun-Yan Zhang, MD, Attending Doctor, Department of Ultrasonography, Nantong Haimen District People’s Hospital, No. 1201 Beijing Road, Haimen District, Nantong 226100, Jiangsu Province, China. klts1223@sohu.com
Received: June 14, 2023
Peer-review started: June 14, 2023
First decision: July 3, 2023
Revised: July 11, 2023
Accepted: July 26, 2023
Article in press: July 26, 2023
Published online: September 27, 2023
Processing time: 100 Days and 4.8 Hours
Abstract
BACKGROUND

Ultrasound is a vital tool for the diagnosis and management of colorectal cancer (CRC). Contrast-enhanced ultrasound (CEUS) is a non-invasive, safe, and cost-effective method for evaluating tumour blood vessels, that play a crucial role in tumour growth and progression.

AIM

To explore CEUS’s role in the quantitative evaluation of CRC blood vessels and their correlation with angiogenesis markers and prognosis.

METHODS

This study prospectively enrolled 100 patients with CRC confirmed by histopathology. All patients received preoperative CEUS examinations. Quantitative parameters, such as peak intensity (PI), time to peak (TTP), and area under the curve (AUC), were derived from time-intensity curve (TIC) analysis. Tumour tissue samples were obtained during surgery and examined immunohistochemically to assess the expression of angiogenesis markers, including vascular endothelial growth factor (VEGF) and microvessel density (MVD). The correlation between CEUS parameters, angiogenesis markers, and clinicopathological features was evaluated using appropriate statistical tests.

RESULTS

Quantitative CEUS parameters (PI, TTP, and AUC) showed significant correlations with VEGF expression (P < 0.001) and MVD (P < 0.001), indicating a strong link between tumour blood vessels and angiogenesis. Increased PI, reduced TTP, and expanded AUC values were significantly related to higher tumour stage (P < 0.001), lymph node metastasis (P < 0.001), and distant metastasis (P < 0.001). Furthermore, these parameters were recognized as independent predictors of overall survival and disease-free survival in multivariate analysis (P < 0.001).

CONCLUSION

CEUS has a high potential in guiding treatment planning and predicting patient outcomes. However, more comprehensive, multicentre studies are required to validate the clinical utility of CEUS in CRC management.

Keywords: Contrast-enhanced ultrasound; Colorectal cancer; Tumour angiogenesis; Prognosis; Microvessel density; Vascular endothelial growth factor; Tumour

Core Tip: This study investigates the role of contrast-enhanced ultrasound (CEUS) in evaluating colorectal cancer (CRC) blood vessels and their correlation with angiogenesis markers and prognosis. The study enrolled 100 patients with CRC, and quantitative CEUS parameters showed significant correlations with angiogenesis markers and clinicopathological features. The study concludes that CEUS has high potential in guiding treatment planning and predicting patient outcomes but requires further validation through multicentre studies.