ABSTRACT
Aim: is to assess the relation between c-Myc oncogene expression and angiogenic factors namely vascular endothelial growth factor [VEGF], funs-like tyrosine kinase 1[Flt-1] in patients with diffuse large B cell lymphoma [DLBCL] and their impact on the patient outcome
Methods: Forty Five DLBCL patients beside 10 normal controls were included. c-Myc oncoprotein was assessed by immunohistochemistry and sVEGF, and sFlt-1 were assessed by immunosorbent assay
Results: c-Myc over-expression was detected in 66.6% of DLBCL. The DLBCL patient group with positive c-Myc overexpression showed significantly higher sVEGF and significantly decreased sFlt-1 as compared to group with negative c-Myc over-expression [P=0.000, 0.009 respectively]. sVEGF was positively correlated to sLDH and .v./32 microglobulin [r =0.6, p;0.000, r =0.69, P= 0.000] respectively. The non-survived DLBCL group showed significantly higher expression of c-Myc, high concentration of sVEGF and lower concentration in sFlt-1 as compared to the living group [P=0.000 for all]
Conclusion: These findings confirm the in vitro based suggestion that c-Myc over-expression orchestrate the angiogenic mritch necessary for tumor progression. c-Myc over-expression, elevated sVEGF, and normal sFlt-1 at diagnosis are poor prognostic markers· in DLBCL patients
ABSTRACT
Left ventricular hypertrophy [LVH] predicts increased risk for ventricular arrhythmias [VAs] which probably accounts for the elevated risk of sudden cardiac death. To investigate the value of signal-averaged electrocardiogram [SAECG] and QT dispersion as noninvasive markers for ventricular arrhythmias in patients with LVH. We subjected 60 patients with LVH;30 hypertensive [group 1], 15 with hypertrophic cardiomyopathy [HCM] [group II] and 15 with valvular aortic stenosis [group III] to a complete echo-Doppler examination, 12-lead electrocardiogram and SAECG for estimation of left ventricular mass index [LVMI], detection of QT dispersion and late diastolic potentials [LDPs]. Ventricular arrhythmias were detected in 32% of patients with LVH. LDPs were detected in 17% of patients with LVH. All patients with LDPs had VAs. All VAs in patients with LDPs were of Lown grade [2] and [3], whereas most of VAs in patients without LDPs were of Lown grade [1]. Patients with LVH had significantly high QT dispersion, QTc dispersion and LVMI when compared to control subjects [P=0.04, 0.03 and 0.01, respectively]. Patients with HCM had significantly high QT dispersion, QTc dispersion and LVMI when compared to group I [P=0.02, 0.03 and 0.02, respectively] and group II [P=0.02, 0.02 and 0.04, respectively]. Significant correlation was found between LVMI and LDPs as well as QT and QTc dispersion [P=0.042 for LDPs, 0.036 for QT dispersion and 0.028 for QTc dispersion]. Of the many ECG and echocardiographic variables subjected to univariate and multivariate analysis, only three were identified as significant independent predictors of VAs: QT, QTc dispersion, LVMI and LDPs [P=0.006 and 0.04 for QT dispersion; 0.008 and 0.043 for QTc dispersion, 0.008 and 0.033 for LVMI and 0.0001 and 0.0001 for LDPs]. QT dispersion, QTc dispersion, LVMI and LDPs may be a useful adjuncts to the noninvasive assessment of patients with LVH, particularly in the prediction of sudden death