Possible Predictive Value of Maspin Expression in Colorectal Cancer

Introduction: The aim of our study was to correlate Maspin expression, a serine protease with possible antiangiogenic and antiproliferative effects, with angiogenesis and to realize a synthesis of the literature data regarding the novel patented compounds used in colorectal cancer (CRC). Materials and methods: In 110 cases with CRC, immunohistochemical stains were performed using Maspin, p53, VEGFA, CD31, and CD105. The results were correlated with the tumor stage and microsatellite status. A new scoring system for Maspin, based on the dual cytoplasmic-nuclear expression, with possible predictive value, was proposed. Results: The angiogenesis presented an oscillating pattern, the VEGF expression was more intense in Stage IV, but the endothelial area that quantified with both CD31 and CD105 was smaller than in those cases diagnosed in Stages II and III. Most of the p53 negative cases with Maspin nuclear predominance, which seems to respond to 5-Fluorouracil, were microsatellite instability (MSI) cases. In Stage II, Maspin nuclear positivity was more specific for pT4 tumors and aggressive cases with high p53 index. Thirty-three percent of CRC diagnosed in Stage II and 27% of those from Stage III presented Maspin expression in the endothelial cells. No cases from Stage IV had Maspin vascular positivity. Conclusions: Maspin nuclear expression, associated with p53 ones, might be used either to select the high-risk microsatellite stable (MSS) colorectal carcinomas diagnosed in Stage II or those MSI cases which can respond to 5-Fluorouracil.