Serum concentrations of insulin, insulin-like growth factor I, vascular endothelial growth factor and gastrin in patients with colon adenomas and colorectal cancer

Introduction: Colon carcinogenesis is a multi-step process in which many growth factors are involved.

Aim: Evaluation of the serum concentrations of selected growth factors in patients with colonic adenomas (CA) and colon cancer (CC).

Material and methods: In 23 patients with CC, 36 patients with CA and in 16 healthy persons serum concentrations of insulin, insulin-like growth factor I (IGF-I), vascular endothelial growth factor (VEGF) and gastrin were analysed.

Results: The VEGF serum levels were elevated in patients with CC compared with healthy patients (624.81 ±113.99 pg/ml vs. 331.43 ±52.87 pg/ml; p < 0.05) and patients with CA (426.18 ±59.71 pg/ml). Elevated VEGF levels were observed particularly in Duke’s C and D stage (788.82 ±178.85 pg/ml vs. 453 ±74.83 pg/ml for Duke’s A i B; p < 0.05). Mean gastrin concentration was significantly higher in patients with CC than in patients with CA and in the control group (respectively: 98.25 ±15.91 µU/ml vs. 64.72 ±6.14 µU/ml and 67.86 ±8.13 µU/ml; p < 0.05). Significantly higher mean concentrations of gastrin were observed in patients with distal tumour localisation compared with proximal (115.46 ±23.26 µU/ml vs. 68.13 ±23.26 µU/ml; p < 0.05) and in tumours at Duke’s A and B stage. There were no significant differences observed in mean serum concentrations of insulin and IGF-I between all groups of patients.

Conclusions: VEGF plays an important role particularly in the late stage of colon carcinogenesis. Increase of serum gastrin concentration in patients with CC concerns exclusively distal tumour localisation. Measurement of gastrin concentration can be an additional prognostic factor in advanced CC.