Effects of laparoscopic radical surgery in the treatment of colorectal cancer and correlations of VEGF and TGF-β1 with prognosis.

Objective: To investigate the effects of laparoscopic radical surgery on the treatment of colorectal cancer (CRC) and explore the correlations of vascular endothelial growth factor (VEGF) and transforming growth factor-β1 (TGF-β1) with prognosis.

Methods: The clinical data of 210 patients with CRC admitted to the Yantai Zhifu Hospital from February 2015 to February 2018 were analyzed retrospectively. Among them, 110 patients were treated with laparoscopic radical surgery and assigned to the observation group, and the rest 100 patients were treated with routine open surgery and included in the open group. The two groups were compared in terms of operation time (OT), intraoperative blood loss (IBL), postoperative exhaust time (PET), length of hospital stays (LOS) and incidence of complications. Patients were also followed up for 3 years to count their survival rates. Serum expression levels of VEGF and TGF-β1, detected by enzyme-linked immunosorbent assays (ELISAs), were compared before and after treatment, and their correlations with patients' clinicopathological data and prognosis were analyzed.

Results: Compared with the open group, patients in the observation group had longer OT, but lower IBL, PET, LOS, and overall incidence of complications. In the observation group, VEGF and TGF-β1 expression after treatment was remarkably lower than that before treatment and that in the open group. A 3-year survival rate of 80.0% was observed in the observation group. Univariate analysis showed that serum VEGF and TGF-β1 expression levels were closely related to Dukes staging and lymph node metastasis (LNM) (<0.05). The Log-Rank test showed that the survival rate of patients with high VEGF and TGF-β1 expression was remarkably lower than that of those with low expression (<0.05). According to Cox model multivariate analysis, Dukes staging, LNM, surgical methods and high VEGF and TGF-β1 expression were all independent risk factors for the prognosis of CRC patients (<0.05).

Conclusion: Laparoscopic radical surgery is effective and safe in treating CRC. VEGF and TGF-β1 are highly expressed in the serum of CRC patients, and are closely related to the tumor staging, LNM and prognosis of patients, which are of great significance for evaluating the condition and prognosis of CRC patients.