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DOI 10.34014/2227-1848-2020-4-74-86

EXPRESSION OF VASCULOENDOTHELIAL AND PLATE GROWTH FACTORS IN PRIMARY COLORECTAL TUMOR AS A PREDICTOR OF EARLY RECURRENCE

 

I.A. Bogomolova, D.R. Dolgova, I.I. Antoneeva, T.P. Gening, T.I. Kuznetsova

Ulyanovsk State University, Ulyanovsk, Russia

 

The prognostic factors that determine colorectal cancer (CRC) treatment are disease status, tumor grade, microsatellite instability, invasion degree, and the index of proliferative activity. However, the assessment of the adjuvant chemotherapy in colorectal cancer does not imply the assessment of angiogenic factors in a primary tumor.

The aim of the paper is to evaluate the prognostic role of PDGFAA and VEGFA expression in tumor tissue of stages II/III colorectal cancers.

Materials and Methods. Paraffin blocks of primary CRC tumor (n=50) were used as study material. Immunohistochemistry (IHC) was used to examine the expression of vasculoendothelial and platelet growth factors and calculate IHC score in the tumor parenchyma and CRC stroma.

Results. According to IHC staining, CRC tumor expresses VEGFA and PDGFAA factors in 92 % of cases, in the resection line – in 37 % of the samples. There were no differences in VEGFA and PDGFAA expression in tumor parenchyma in CRC, depending on the process stage and grade degree. The cumulative risk of disease progression within a year after surgery in patients with stage II/III CRC with VEGFA+PDGFAA overexpression in the primary tumor is 4.9 times higher (CI 2.123–11.089, p=0.011) compared to the group of patients with reduced expression of the studied angiogenic factors.

Conclusions. The data obtained suggest that co-expression of angiogenic VEGFA and PDGFAA factors in the tumor may reflect the initial CRC regarding neoangiogenesis. If VEGFA and/or PDGFAA IHC score is more or equal to 6, the risk of disease recurrence within 1 year from the start of medical observation increases, which is an unfavorable prognostic factor.

Keywords: colorectal cancer, vasculoendothelial growth factor, platelet growth factor, adjuvant chemotherapy.

Conflict of interest. The authors declare no conflict of interest.

 

References

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5. Roberta M., Manzat S., Balacescu L., Gherman C., Chira R.I., Craiu A., Mircea P.A., Lisencu C., Balacescu O. The Role of PDGFs and PDGFRs in Colorectal Cancer. Mediators of Inflammation. 2017; 2017: 4708076.

6. Jiang B., Chen J., Yuan W., Ji J., Liu Z., Wu L., Tang, Q., Shu X. Platelet-derived growth factor-D promotes colorectal cancer cell migration, invasion and proliferation by regulating Notch1 and matrix metalloproteinase-9. Oncology Letters. 2018; 15 (2): 1573–1579.

7. Kim M.S., Choi H.S., Wu M. Potential Role of PDGFRβ-Associated THBS4 in Colorectal Cancer Development. Cancers (Basel). 2020; 12 (9): 2533.

8. Chen J., Yuan W., Wu L., Tang Q., Xia Q., Ji J. PDGF-D promotes cell growth, aggressiveness, angiogenesis and EMT transformation of colorectal cancer by activation of Notch1/Twist1 pathway. Oncotarget. 2017; 8 (6): 9961–9973.

9. Olsen R.S., Dimberg J., Geffers R., Wågsäter D. Possible Role and Therapeutic Target of PDGF-D Signalling in Colorectal Cancer. Cancer Invest. 2019; 37 (2): 99–112.

10. Lindmark G., Sundberg C., Glimelius B., Pahlman L., Rubin K., Gerdin B. Stromal expression of platelet-derived growth factor beta-receptor and platelet-derived growth factor B-chain in colorectal cancer. Lab. Invest. 1993; 69 (6): 682–689.

11. Sundberg C., Ljungstrom M., Lindmark G., Gerdin B., Rubin K. Microvascular pericytes express platelet-derived growth factor-beta receptors in human healing wounds and colorectal adenocarcinoma. Am. J. Pathol. 1993; 143 (5): 1377–1388.

12. Fedyanin M.Yu., Gladkov O.A., Gordeev S.S., Rykov I.V., Tryakin A.A. Prakticheskie rekomendatsii po lekarstvennomu lecheniyu raka obodochnoy kishki i rektosigmoidnogo soedineniya [Practical guidelines for medical treatment of colon and rectosigmoid junction cancer]. Zlokachestvennye opukholi. 2019; 9 (3s2): 324–364 (in Russian).

13. Chibaudel B., Henriques J., Rakez M., Brenner B., Won Kim T., Martinez-Villacampa M., Gallego-Plazas J., Cervantes A., Shim K., Jonker D., Guerin-Meyer V., Mineur L., Banzi C., Dewdney A., Dejthevaporn T., Bloemendal H., Roth A., Moehler M., Aranda E., Cutsem E.V., Tabernero J., Schmoll H.-J., Hoff P., André T., de Gramont A. Association of Bevacizumab Plus Oxaliplatin-Based Chemotherapy With Disease-Free Survival and Overall Survival in Patients With Stage II Colon Cancer: A Secondary Analysis of the AVANT Trial. JAMA Network Open. 2020; 3 (10): e2020425.

14. Lizárraga-Verdugo E., Avendaño-Félix M., Bermúdez M., Ramos-Payán R., Pérez-Plasencia C. Cancer Stem Cells and Its Role in Angiogenesis and Vasculogenic Mimicry in Gastrointestinal Cancers. Frontiers in oncology. 2020; 10: 413.

15. Bhattacharya R., Fan F., Wang R., Ye X., Xia L., Boulbes D., Ellis M.L. Intracrine VEGF signalling mediates colorectal cancer cell migration and invasion. Br. J. Cancer. 2017; 117: 848–855.

16. Dinami R., Porru M., Amoreo C.A., Sperduti I., Mottolese M., Buglioni S., Marinelli D., Maugeri-Saccà M., Sacconi A., Blandino G., Leonetti C., Di Rocco G., Verdina A., Spinella F., Fiorentino F., Ciliberto G., Biroccio A., Zizza P. TRF2 and VEGF-A: an unknown relationship with prognostic impact on survival of colorectal cancer patients. J. Exp. Clin. Cancer Res. 2020; 39: 111.

17. Medves S., Duhoux F., Ferrant A., Toffalini F., Ameye G., Libouton J.-M., Poirel H.A., Demoulin J.-B. KANK1, a candidate tumor suppressor gene, is fused to PDGFRB in an imatinib responsive myeloid neoplasm with severe thrombocythemia. Leukemia. 2010; 24: 1052–1055.

18. Terris B., Scoazec J.Y., Rubbia L., Bregeaud L., Pepper M.S., Ruszniewski P., Belghiti J., Fléjou J., Degott C. Expression of vascular endothelial growth factor in digestive neuroendocrine tumours. Histopathology. 1998; 32: 133–138.

19. Kang S.M., Maeda K., Onoda N., Chung Y.S., Nakata B., Nishiguchi Y., Sowa M. Combined analysis of p53 and vascular endothelial growth factor expression in colorectal carcinoma for determination of tumor vascularity and liver metastasis. Int. J. Cancer. 1997; 74 (5): 502–507.

20. Zafirellis K., Agrogiannis G., Zachaki A., Gravani K., Karameris A., Kombouras C. Prognostic significance of VEGF expression evaluated by quantitative immunohistochemical analysis in colorectal cancer. J. Surg. Res. 2008; 147 (1): 99–107.

21. Des Guetz G., Uzzan B., Nicolas P., Cucherat M., Morere J.F., Benamouzig R., Breau J.-L., Perret G.-Y. Microvessel density and VEGF expression are prognostic factors in colorectal cancer. Meta-analysis of the literature. Br. J. Cancer. 2006; 94 (12): 1823–1832.

22. Lee J.C., Chow N.H., Wang S.T., Huang S.M. Prognostic value of vascular endothelial growth factor expression in colorectal cancer patients. Eur. J. Cancer. 2000; 36 (6): 748–753.

23. Takahashi Y., Tucker S.L., Kitadai Y., Koura A.N., Bucana C.D., Cleary K.R., Ellis L.M. Vessel counts and expression of vascular endothelial growth factor as prognostic factors in node-negative colon cancer. Arch. Surg. 1997; 132 (5): 541–546.

24. Zheng S., Han M.Y., Xiao Z.X., Peng J.P., Dong Q. Clinical significance of vascular endothelial growth factor expression and neovascularizationin colorectal carcinoma. World J. Gastroenterol. 2003; 9 (6): 1227–1230.

25. Zygon J., Szajewski M., Kruszewski W.J., Rzepko R. VEGF, Flt-1, and microvessel density in primary tumors as predictive factors of colorectal cancer prognosis. Mol. Clin. Oncol. 2017; 6 (2): 243–248.

26. Saad R.S., Liu Y.L., Nathan G., Celebrezze J., Medich D., Silverman J.F. Endoglin (CD105) and vascular endothelial growth factor as prognostic markers in colorectal cancer. Mol. Pathol. 2004; 17 (2): 197–203.

27. Martins S.F., Reis R.M., Rodrigues A.M., Baltazar F., Filho A.L. Role of endoglin and VEGF family expression in colorectal cancer prognosis and anti-angiogenic therapies. World J. Clin. Oncol. 2011; 2 (6): 272–280.

Received 19 August 2020; accepted 15 October 2020.

 

Information about the authors

Bogomolova Irina Aleksandrovna, Teaching Assistant, Chair of Physiology and Pathophysiology, Medical Department named after T.Z. Biktimirov, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy St., 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-3331-8632.

Dolgova Dinara Rishatovna, Candidate of Sciences (Biology), Associate Professor, Chair of Physiology and Pathophysiology, Medical Department named after T.Z. Biktimirov, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy St., 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0001-5475-7031.

Antoneeva Inna Ivanovna, Doctor of Sciences (Medicine), Professor, Chair of Oncology and Radiation Diagnostics, Medical Department named after T.Z. Biktimirov, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy St., 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-1525-2070.

Gening Tat'yana Petrovna, Doctor of Sciences (Biology), Professor, Head of the Chair of Physiology and Pathophysiology, Medical Department named after T.Z. Biktimirov, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy St., 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-5117-1382.

Kuznetsova Tat'yana Ivanovna, Candidate of Sciences (Biology), Associate Professor, Chair of Morphology, Medical Department named after T.Z. Biktimirov, Ulyanovsk State University. 432017, Russia, Ulyanovsk,L. Tolstoy St., 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-0909-734X.

 

For citation

Bogomolova I.A., Dolgova D.R., Antoneeva I.I., Gening T.P., Kuznetsova T.I. Ekspressiya vaskuloendotelial'nogo i trombotsitarnogo faktorov rosta v pervichnoy opukholi kolorektal'nogo raka kak faktor prognoza rannego retsidiva [Expression of vasculoendothelial and platelet growth factors in primary colorectal tumors as a predictor of early recurrence]. Ul'yanovskiy mediko-biologicheskiy zhurnal. 2020; 4: 74–86. DOI: 10.34014/2227-1848-2020-4-74-86 (in Russian).

 

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УДК 616.34-006.6:616-08-059

DOI 10.34014/2227-1848-2020-4-74-86

ЭКСПРЕССИЯ ВАСКУЛОЭНДОТЕЛИАЛЬНОГО И ТРОМБОЦИТАРНОГО ФАКТОРОВ РОСТА В ПЕРВИЧНОЙ ОПУХОЛИ КОЛОРЕКТАЛЬНОГО РАКА КАК ФАКТОР ПРОГНОЗА РАННЕГО РЕЦИДИВА

 

И.А. Богомолова, Д.Р. Долгова, И.И. Антонеева, Т.П. Генинг, Т.И. Кузнецова

ФГБОУ ВО «Ульяновский государственный университет», г. Ульяновск, Россия

 

Прогностическими факторами, определяющими тактику лечения при колоректальном раке (КРР), являются стадия заболевания, степень дифференцировки опухоли, микросателлитная нестабильность, степень инвазии, индекс пролиферативной активности. При этом оценка эффективности адъюватной химиотерапии при КРР не предполагает оценку ангиогенных факторов в первичной опухоли.

Цель работы – оценить прогностическую роль экспрессии PDGFAA и VEGFA в опухолевой ткани на II–III стадиях колоректального рака.

Материалы и методы. В качестве материала для исследования использованы парафиновые блоки первичной опухоли КРР (n=50). С помощью метода ИГХ исследована экспрессия васкулоэндотелиального и тромбоцитарного факторов роста путем расчета ИГХ-балла в опухолевой паренхиме и строме КРР.

Результаты. По результатам ИГХ-окрашивания опухоль КРР экспрессирует факторы VEGFA и PDGFAA в 92 % случаев, в линии резекции – в 37 % образцов. Отличий в экспрессии VEGFA и PDGFAA в опухолевой паренхиме при КРР в зависимости от стадии процесса, степени дифференцировки выявлено не было. Кумулятивный риск прогрессирования заболевания в течение года после операции у больных с КРР II–III стадий при гиперэкспрессии VEGFA+PDGFAA в первичной опухоли выше в 4,9 раза (ДИ 2,123–11,089, р=0,011) по сравнению с группой пациентов со сниженной продукцией изученных ангиогенных факторов.

Выводы. Полученные данные позволяют предполагать, что коэкспрессия ангиогенных факторов VEGFA и PDGFAA в опухоли может отражать исходный профиль КРР в отношении неоангиогенеза. При ИГХ-балле VEGFA и/или PDGFAA выше или равном 6 возрастает риск рецидива заболевания в течение 1 года от момента начала наблюдения, что является неблагоприятным прогностическим фактором.

Ключевые слова: колоректальный рак, васкулоэндотелиальный фактор роста, тромбоцитарный фактор роста, адъювантная химиотерапия.

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

 

Литература

1. Каприна А.Д., Старинский В.В., Петрова Г.В., ред. Злокачественные новообразования в России в 2018 году (заболеваемость и смертность). М.: МНИОИ им. П.А. Герцена, филиал ФГБУ «НМИЦ радиологии»; 2019. 236.

2. Федянин М.Ю. Адъювантная терапия больных раком толстой кишки II стадии – трудное решение для химиотерапевта. Злокачественные опухоли. 2019; 9 (3s1): 15–22.

3. Laurent-Puig P., Marisa L., Taieb J. Colon cancer molecular subtype intratumoral heterogeneity and its prognostic impact: An extensive molecular analysis of the PETACC-8. Annals of Oncology. 2018; 29 (suppl. 8): 60.

4. Bosman F.T., Carneiro F., Hruban R.H., Theise N.D. WHО classification of tumors the digestive system. Vol. 3. 4th Edition. Lyon; 2010. 417.

5. Roberta M., Manzat S., Balacescu L., Gherman C., Chira R.I., Craiu A., Mircea P.A., Lisencu C., Balacescu O. The Role of PDGFs and PDGFRs in Colorectal Cancer. Mediators of Inflammation. 2017; 2017: 4708076.

6. Jiang B., Chen J., Yuan W., Ji J., Liu Z., Wu L., Tang, Q., Shu X. Platelet-derived growth factor-D promotes colorectal cancer cell migration, invasion and proliferation by regulating Notch1 and matrix metalloproteinase-9. Oncology Letters. 2018; 15 (2): 1573–1579.

7. Kim M.S., Choi H.S., Wu M. Potential Role of PDGFRβ-Associated THBS4 in Colorectal Cancer Development. Cancers (Basel). 2020; 12 (9): 2533.

8. Chen J., Yuan W., Wu L., Tang Q., Xia Q., Ji J. PDGF-D promotes cell growth, aggressiveness, angiogenesis and EMT transformation of colorectal cancer by activation of Notch1/Twist1 pathway. Oncotarget. 2017; 8 (6): 9961–9973.

9. Olsen R.S., Dimberg J., Geffers R., Wågsäter D. Possible Role and Therapeutic Target of PDGF-D Signalling in Colorectal Cancer. Cancer Invest. 2019; 37 (2): 99–112.

10. Lindmark G., Sundberg C., Glimelius B., Pahlman L., Rubin K., Gerdin B. Stromal expression of platelet-derived growth factor beta-receptor and platelet-derived growth factor B-chain in colorectal cancer. Lab. Invest. 1993; 69 (6): 682–689.

11. Sundberg C., Ljungstrom M., Lindmark G., Gerdin B., Rubin K. Microvascular pericytes express platelet-derived growth factor-beta receptors in human healing wounds and colorectal adenocarcinoma. Am. J. Pathol. 1993; 143 (5): 1377–1388.

12. Федянин М.Ю., Гладков О.А., Гордеев С.С., Рыков И.В., Трякин А.А. Практические рекомендации по лекарственному лечению рака ободочной кишки и ректосигмоидного соединения. Злокачественные опухоли. 2019; 9 (3s2): 324–364.

13. Chibaudel B., Henriques J., Rakez M., Brenner B., Won Kim T., Martinez-Villacampa M., Gallego-Plazas J., Cervantes A., Shim K., Jonker D., Guerin-Meyer V., Mineur L., Banzi C., Dewdney A., Dejthevaporn T., Bloemendal H., Roth A., Moehler M., Aranda E., Cutsem E.V., Tabernero J., Schmoll H.-J., Hoff P., André T., de Gramont A. Association of Bevacizumab Plus Oxaliplatin-Based Chemotherapy With Disease-Free Survival and Overall Survival in Patients With Stage II Colon Cancer: A Secondary Analysis of the AVANT Trial. JAMA Network Open. 2020; 3 (10): e2020425.

14. Lizárraga-Verdugo E., Avendaño-Félix M., Bermúdez M., Ramos-Payán R., Pérez-Plasencia C. Cancer Stem Cells and Its Role in Angiogenesis and Vasculogenic Mimicry in Gastrointestinal Cancers. Frontiers in oncology. 2020; 10: 413.

15. Bhattacharya R., Fan F., Wang R., Ye X., Xia L., Boulbes D., Ellis M.L. Intracrine VEGF signalling mediates colorectal cancer cell migration and invasion. Br. J. Cancer. 2017; 117: 848–855.

16. Dinami R., Porru M., Amoreo C.A., Sperduti I., Mottolese M., Buglioni S., Marinelli D., Maugeri-Saccà M., Sacconi A., Blandino G., Leonetti C., Di Rocco G., Verdina A., Spinella F., Fiorentino F., Ciliberto G., Biroccio A., Zizza P. TRF2 and VEGF-A: an unknown relationship with prognostic impact on survival of colorectal cancer patients. J. Exp. Clin. Cancer Res. 2020; 39: 111.

17. Medves S., Duhoux F., Ferrant A., Toffalini F., Ameye G., Libouton J.-M., Poirel H.A., Demoulin J.-B. KANK1, a candidate tumor suppressor gene, is fused to PDGFRB in an imatinib responsive myeloid neoplasm with severe thrombocythemia. Leukemia. 2010; 24: 1052–1055.

18. Terris B., Scoazec J.Y., Rubbia L., Bregeaud L., Pepper M.S., Ruszniewski P., Belghiti J., Fléjou J., Degott C. Expression of vascular endothelial growth factor in digestive neuroendocrine tumours. Histopathology. 1998; 32: 133–138.

19. Kang S.M., Maeda K., Onoda N., Chung Y.S., Nakata B., Nishiguchi Y., Sowa M. Combined analysis of p53 and vascular endothelial growth factor expression in colorectal carcinoma for determination of tumor vascularity and liver metastasis. Int. J. Cancer. 1997; 74 (5): 502–507.

20. Zafirellis K., Agrogiannis G., Zachaki A., Gravani K., Karameris A., Kombouras C. Prognostic significance of VEGF expression evaluated by quantitative immunohistochemical analysis in colorectal cancer. J. Surg. Res. 2008; 147 (1): 99–107.

21. Des Guetz G., Uzzan B., Nicolas P., Cucherat M., Morere J.F., Benamouzig R., Breau J.-L., Perret G.-Y. Microvessel density and VEGF expression are prognostic factors in colorectal cancer. Meta-analysis of the literature. Br. J. Cancer. 2006; 94 (12): 1823–1832.

22. Lee J.C., Chow N.H., Wang S.T., Huang S.M. Prognostic value of vascular endothelial growth factor expression in colorectal cancer patients. Eur. J. Cancer. 2000; 36 (6): 748–753.

23. Takahashi Y., Tucker S.L., Kitadai Y., Koura A.N., Bucana C.D., Cleary K.R., Ellis L.M. Vessel counts and expression of vascular endothelial growth factor as prognostic factors in node-negative colon cancer. Arch. Surg. 1997; 132 (5): 541–546.

24. Zheng S., Han M.Y., Xiao Z.X., Peng J.P., Dong Q. Clinical significance of vascular endothelial growth factor expression and neovascularizationin colorectal carcinoma. World J. Gastroenterol. 2003; 9 (6): 1227–1230.

25. Zygon J., Szajewski M., Kruszewski W.J., Rzepko R. VEGF, Flt-1, and microvessel density in primary tumors as predictive factors of colorectal cancer prognosis. Mol. Clin. Oncol. 2017; 6 (2): 243–248.

26. Saad R.S., Liu Y.L., Nathan G., Celebrezze J., Medich D., Silverman J.F. Endoglin (CD105) and vascular endothelial growth factor as prognostic markers in colorectal cancer. Mol. Pathol. 2004; 17 (2): 197–203.

27. Martins S.F., Reis R.M., Rodrigues A.M., Baltazar F., Filho A.L. Role of endoglin and VEGF family expression in colorectal cancer prognosis and anti-angiogenic therapies. World J. Clin. Oncol. 2011; 2 (6): 272–280.

Поступила в редакцию 19.08.2020; принята 15.10.2020.

 

Авторский коллектив

Богомолова Ирина Александровна – асcистент кафедры физиологии и патофизиологии медицинского факультета им. Т.З. Биктимирова, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-3331-8632.

Долгова Динара Ришатовна – кандидат биологических наук, доцент кафедры физиологии и патофизиологии медицинского факультета им. Т.З. Биктимирова, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0001-5475-7031.

Антонеева Инна Ивановна – доктор медицинских наук, профессор кафедры онкологии и лучевой диагностики медицинского факультета им. Т.З. Биктимирова, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-1525-2070.

Генинг Татьяна Петровна – доктор биологических наук, профессор, заведующая кафедрой физиологии и патофизиологии медицинского факультета им. Т.З. Биктимирова, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-5117-1382.

Кузнецова Татьяна Ивановна – кандидат биологических наук, доцент кафедры морфологии медицинского факультета им. Т.З. Биктимирова, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-0909-734X.

 

Образец цитирования

Богомолова И.А., Долгова Д.Р., Антонеева И.И., Генинг Т.П., Кузнецова Т.И. Экспрессия васкулоэндотелиального и тромбоцитарного факторов роста в первичной опухоли колоректального рака как фактор прогноза раннего рецидива. Ульяновский медико-биологический журнал. 2020; 4: 74–86. DOI: 10.34014/2227-1848-2020-4-74-86.