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Journal of Oncology
Volume 2012, Article ID 907971, 12 pages
Research Article

Histopathological Growth Pattern, Proteolysis and Angiogenesis in Chemonaive Patients Resected for Multiple Colorectal Liver Metastases

1Department of Oncology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
2The Finsen Laboratory, Rigshospitalet, Copenhagen University Hospital, 2200 Copenhagen, Denmark
3Biotech Research and Innovation Centre (BRIC), Copenhagen University, 2200 Copenhagen, Denmark
4Translational Cancer Research Unit, GZA Hospitals St.-Augustinus, 2610, Antwerp, Belgium
5Departments of Surgery, Medicine and Oncology, McGill University Health Center, McGill University, Montreal, Quebec, Canada H3A 1A1
6Department of Pathology, The Gade Institute, Haukeland Hospital, 5021 Bergen, Norway
7Department of Surgery, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
8Department of Pathology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark

Received 2 April 2012; Accepted 11 June 2012

Academic Editor: Claudia Lanari

Copyright © 2012 Rikke Løvendahl Eefsen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The purpose of this study was to characterise growth patterns, proteolysis, and angiogenesis in colorectal liver metastases from chemonaive patients with multiple liver metastases. Twenty-four patients were included in the study, resected for a median of 2.6 metastases. The growth pattern distribution was 25.8% desmoplastic, 33.9% pushing, and 21% replacement. In 20 patients, identical growth patterns were detected in all metastases, but in 8 of these patients, a second growth pattern was also present in one or two of the metastases. In the remaining 4 patients, no general growth pattern was observed, although none of the liver metastases included more than two growth patterns. Overall, a mixed growth pattern was demonstrated in 19.3% of the liver metastases. Compared to metastases with pushing, those with desmoplastic growth pattern had a significantly up-regulated expression of urokinase-type plasminogen activator receptor ( 𝑃 = 0 . 0 0 0 8 ). Angiogenesis was most pronounced in metastases with a pushing growth pattern in comparison to those with desmoplastic ( 𝑃 = 0 . 0 0 0 7 ) and replacement growth pattern ( 𝑃 = 0 . 0 2 1 ). Although a minor fraction of the patients harboured metastases with different growth patterns, we observed a tendency toward growth pattern uniformity in the liver metastases arising in the same patient. The result suggests that the growth pattern of liver metastases is not a random phenomenon.