Von Willebrand factor in colorectal cancer

Background and aim: Von Willebrand factor (vWF) is a protein that mediates adherence of platelets to subendothelium during primary hemostasis. High vWF plasma concentrations have been reported in patients with various types of cancer, such as squamous cell carcinoma of the larynx and the cervix. This effect is associated with tumor-related angiogenesis and the metastatic process. The aim of this study was to determine plasma levels of vWF in a series of patients with colorectal carcinoma and the correlation of these values with specific prognostic predictors for the disease. Patients and methods: vWF was measured by quantitative immunoelectrophoresis in 75 patients with colorectal carcinoma at various Dukes' stages and compared with results from 88 healthy controls. Results: Cancer patients had significantly higher vWF concentrations than controls. vWF plasma levels were associated with tumor staging, invasion of adjacent organs by the tumor, and presence of distant metastases. There was no significant correlation between vWF values and tumor size, histological grading, or plasma carcinoembryonic antigen levels. Conclusions: The levels of vWF are elevated in patients with colorectal cancer, and these values tend to increase with tumor progression. Considering that vWF is related to the process of tumor angiogenesis and may contribute to metastatic dissemination of malignant cells, further studies of its potential role as a marker of tumor progression in patients with colorectal cancer are warranted. It should be pointed out, however, that these observations need to be substantiated with additional studies using other methods and, preferably, the determination of vWF levels synthesized in the tumor tissues.