The Relationship Between Vascular Endothelial Growth Factor Expression in T Cell Subsets and Survival of Patients With Colorectal Cancer

Background/Aim: Angiogenesis and immune modulation are integral to colorectal cancer (CRC) progression. Vascular endothelial growth factor receptor (VEGFR) is expressed not only on endothelial cells but also on lymphocytes, where it may modulates immune activity. However, its distribution on peripheral T-cell subsets and prognostic relevance in CRC remain poorly understood. Materials and Methods: We prospectively analyzed 52 histologically confirmed patients with CRC and 30 healthy controls. VEGFR2 expression on T-cell subsets [Th1, Th2, Th17, and cytotoxic T lymphocytes (CTLs)] was quantified using flow cytometry. Associations between VEGFR expression and overall survival (OS) were examined using median fluorescence intensity (MFI) and percentage values. Results: VEGFR expression was significantly elevated in lymphocytes and Th1 cells of patients with CRC compared with controls. Th1 levels were increased, particularly in advanced-stage disease (p=0.01). VEGFR expression in Th1, Th2, and CD8⁺ CTLs was higher than that in controls (p=0.04, p=0.03, and p<0.001, respectively). Early-stage patients exhibited greater VEGFR expression in Th1 and Th17 subsets than both advanced-stage and control groups (p=0.01 and p=0.04). Patients with Th1 ≤14.7% had longer median OS (43.4 vs. 21.7 months, p=0.002), whereas higher Th9 (>10.7%) and Th17 (>11.2%) levels predicted better survival (p=0.001 and p=0.027). Lower VEGFR expression in Th1 (≤212 MFI), Th2 (≤268 MFI) and Th17 (≤285 MFI) subsets correlated with shorter OS (p=0.018, p=0.031, and p=0.031, respectively), indicating that VEGFR over-expression within these subsets may be associated with favorable prognosis. Conclusion: VEGFR expression on peripheral T-cell subsets correlates with survival in CRC, suggesting its potential role as a prognostic and immunoregulatory biomarker.