Angiogenic cells, macroparticles and RNA transcripts in laparoscopic vs. open surgery for colorectal cancer

Background: Angiogenesis is crucial for tissue repair and cancer progression. We investigated a panel of angiogenic cells, macroparticles and RNA transcripts before, during and after laparoscopic colectomy or open colectomy for colorectal cancer. Results: Viable and apoptotic circulating endothelial cells were significantly increased after open but not after laparoscopic colectomy (p <0.01). A significant decrease of circulating mRNA coding for VEGFR-C and D and PDGFR-β was found after laparoscopic but not after open colectomy. Methods: A total of 24 patients were enrolled. Viable and apoptotic circulating endothelial cells, progenitors and macroparticles were evaluated by flow cytometry. The number of copies of angiogenesis-related RNA transcripts were evaluated by quantitative PCR. Conclusion: Open, but not laparoscopic colectomy, was associated with a significant post-operative increase in circulating endothelial cells, either apoptotic (likely due to surgery-related vascular damage) and viable (likely representing vascular remodeling). Circulating RNA copies coding for some angiogenic genes were significantly decreased after laparoscopic colectomy likely because of the removal of the tumor lesion. This decrease was not observed after open colectomy, were a more pronounced wave of angiogenesis related to wound healing was expected. These results indicate a relevant wave of angiogenesis-related cells and transcripts after open but not after laparoscopic colectomy.