Li MH, Li WW, He L, Li JF, Zhang SY. Quantitative evaluation of colorectal tumour vasculature using contrast-enhanced ultrasound: Correlation with angiogenesis and prognostic significance. World J Gastrointest Surg 2023; 15(9): 2052-2062 [PMID: 37901730 DOI: 10.4240/wjgs.v15.i9.2052]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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
ARTICLE HIGHLIGHTS
Research background
The background of this research study highlights the importance of ultrasound in the diagnosis and management of colorectal cancer (CRC). Contrast-enhanced ultrasound (CEUS) is a non-invasive, safe, and cost-effective method that allows for the evaluation of tumor blood vessels. Tumor angiogenesis, which involves the formation of new blood vessels, plays a critical role in tumor growth and progression.
Research motivation
The aim of this study was to investigate the role of CEUS in quantitatively assessing CRC blood vessels and their correlation with angiogenesis markers and prognosis.
Research objectives
Explore the role of CEUS in quantitative assessment of blood vessels in CRC and its correlation with angiogenic markers and prognosis. This study aims to prospectively recruit 100 CRC patients confirmed by histopathology and conduct preoperative CEUS examination.
Research methods
This study enrolled 100 patients with confirmed CRC through histopathology. Preoperative CEUS examinations were performed on all patients. From the CEUS images, quantitative parameters including peak intensity (PI), time to peak (TTP), and area under the curve (AUC) were derived using time-intensity curve analysis. During surgery, tumor tissue samples were obtained and examined immunohistochemically for the expression of angiogenesis markers, such as vascular endothelial growth factor (VEGF) and microvessel density (MVD). The researchers used appropriate statistical tests to evaluate the correlations between CEUS parameters, angiogenesis markers, and clinicopathological features.
Research results
The study findings revealed significant associations between the quantitative CEUS parameters (PI, TTP, and AUC) and VEGF expression, MVD, tumor stage, lymph node metastasis, distant metastasis, overall survival, and disease-free survival. The study concluded that CEUS holds potential for guiding treatment planning and predicting patient outcomes in CRC management but emphasized the need for more comprehensive multicenter studies to validate its clinical utility.
Research conclusions
Demonstrated that CEUS has a significant role in the quantitative evaluation of CRC blood vessels. The quantitative CEUS parameters (PI, TTP, and AUC) showed strong correlations with angiogenesis markers, specifically VEGF expression and MVD. These findings indicate the importance of tumor blood vessels in angiogenesis and tumor progression.
Research perspectives
The study demonstrates the potential of CEUS in guiding treatment decisions and predicting patient outcomes in CRC, further comprehensive studies involving multiple centers are necessary to validate its clinical utility.
