Study of angiogenic factors: Vascular endothelial growth factor [VEGF] and basic fibroblast growth factor [bFGF] in hepatocellular carcinoma

Hepatocellular carcinoma [HCC] is one of the most commonmalignancies in the world. Hepatocellular carcinoma is characterized by high vascularity, so tumor angiogenesis nowadays has been considered to be a strong prognostic factor in patients with HCC .The pre-therapeutic serum vascular endothelial growth factor[VEGF] and basic fibroblast growth factor [bFGF] levels in the HCC patients appear to reflect the disease's potential activity of vascular invasion and metastasis. The pre-therapeutic serum levels of the angiogenic factors VEGF and bFGF were detected in the sera of HCC patients to find new markers to be used for diagnosis of HCC, and were compared with the routinely used tumor markers used for diagnosis of HCC as AFP, CEA, and CA19.9. The relation between the serum levels of VEGF, and bFGF and the clinical characteristics of HCC was also elucidated. On comparing the studied tumor markers among the three studied groups, all the tumor markers were highest in the HCC group, followed the benign liver diseases, and lastly the normal control group [p-value= <0.001 each]. On comparing the studied tumor markers according to different prognostic factors, only AFP showed statistically significant result with the tumor size

Study of some tumor markers and their use in breast cancer relapse

Tissue polypeptide antigen [TPA], cancer antigen 15-3 [CA15.3] and carcinoembryonic antigen[CEA] were evaluated by ELISA in 61 patients of breast cancer to evaluate their role in breast cancer relapse, as well as 16 apparently healthy age matched females as control group. The patients were divided into: Post operative group [26 patients] and relapse group [35 patients], eight patients with local recurrent breast cancer and 27 patients with distant metastasis at different sites. Statistically significant elevation was found for the three tested markers in the relapse group compared to the control and post operative group [P < 0.001], also a statistically significant elevation was found in CEA, CA15.3 and TPA in metastatic group compared to local recurrence group [P = 0.01, 0.03 and 0.01 respectively]. TPA level was statistically higher in grade III than in grade II [P = 0.0009]. In relapse group, right sided tumor showed statistically significant elevation of CEA, TPA than the left sided tumor [P = 0.005 and 0.03 respectively]. According to TNM staging CEA showed statistically significant correlation between Ml and Mo [P = 0.01]. In relapse group CA15.3 showed a statistically significant difference between tumor sized > 2 cm and tumor < 2cm [P = 0.04]. In the relapse group there was a statistically significant correlation between multiple lesions and solitary lesions [P = 0.02]. Among the same group there was a significant positive correlation between the percentage of L.N positivity and each of CEA, CA15.3 and TPA. [r - 0.04, 0.42 and 0.51] [P - 0.03, 0.02 and 0.003 respectively]. Another positive correlation was found between tumor size and L.N positivity [r = 0.44] [p = 0.01]. In both post - operative and relapse group there were positive correlations between CA15.3 and CEA [r - 0.45 and 0.56] [P = 0.02 and 0.001 respectively] Positive correlations were found similarly between TPA and CEA [r - 0.50] [P - 0.003] and CA15.3 and TPA [r - 0.57] [P<0.001] in relapse group. Evaluation of tumor markers, separately showed acceptable accuracy profiles regarding the relapse and distant metastatic patients, with CEA being the most sensitive marker, followed by CA15.3 and lastly TPA. In relapse group the most useful combinations for diagnosis could be [CEA and CA15.3] double combination and [CEA, CA15.3 and TPA] triple combination. In distant metastasis group, the combination of choice could be [CEA and TPA] or [CEA and CA15.3] double combinations and CEA, CA15.3 and TPA] triple combination. The use of the 3 markers merit is to be tried in greater number of breast cancer patients

Prognostic significance of some tumor markers in head and neck carcinomas

Carcinoembryonic antigen [CEA], ferritin, tissue polypeptide antigen [TPA] and alkaline phosphatase [ALP] isoenzymes were evaluated in 41 patients with head and neck cancer before and [2-6] months after receiving treatment. The study included as well 13 apparently healthy age matched individuals as control group. Statistically significant elevation was found for CEA, ferritin, TPA and ALP in the patients before treatment compared to the control [P = 0.001, 0.0001, 0.04, 0.001 respectively], another statistically significant elevation was found for all the studied markers in patients before treatment compared to their levels after treatment [P < 0.001 for CEA, ferritin, TPA and ALP and 0.001 for PALP]. Ferritin was the only marker that showed statistically significant elevation in grade III compared to grade I and II [p - 0.001]. A significant elevation could be detected in the level of TPA and PALP in patients with positive regional L.N mecastasis compared with those without regional L.N metastasis [P = 0.03 and 0.04 respectively]. A statistically significant positive correlation was detected between ferritin level and tumor grade [r = 0.5, P 4 X 001]. Also a statistically significant negative correlations were found between TPA and regional L.N metastasis [r = -0.3, P = 0.04] and between ALP and CEA mean values in treated patients [r = -0.4, p = 0.009] Evaluation of tumor markers, separately revealed that CEA and then ferritin showed higher sensitivity [97.6 percent and 94.6 percent respectively], followed by ALP and TPA [75.6 percent and 5 8.3 percent respectively]. The specificity of CEA was higher than the other studied markers [100 percent]. As regards double combination, it was found that [CEA and ferritin] combination showed the highest sensitivity and specificity followed by [CEA and ALP] and [ferritin and ALP] [sensitivity, [either abnormal] 89 percent, 90 percent and 81 percent for the three previous combination respectively, [both abnormal] 46 percent, 23 percent, and 32 percent respectively] [specificity, "either abnormal" and "both abnormal was 100 percent and 92 percent for [CEA and Ferritin] and [CEA and ALP] respectively, and 100 percent and 85 percent for [ferritin and ALP]. All the triple combinations showed much lower sensitivity and specificity. Sixty one of untreated patients gave PALP bands. After treatment a reduction in PALP percentage was seen in 82 percent of patients. This reduction in PALP activity correlated to tumor stage, being one of the prognostic factors. A strategy requiring 2 or more markers to be abnormal while having both sensitivity and specificity high in monitoring head and neck cancer patients or detecting recurrence could be attained by trying more tumor markers to make firm conclusion

biological significance of laminin and fibronectin in bladder cancer

Laminin [LnP1] and fibronectin [Fn] were estimated in the sera of 27 cases with bladder carcinoma of different histopathological types: Papillary superficial transitional cell carcinoma [TCC] [nine cases], invasive TCC [12 cases] and squamous cell carcinoma [six cases]. Only 18 patients were followed up after treatment. Ten normal individuals and 12 cases suffering from benign bladder lesions were included in the study for comparison. Serum LnP1 was significantly higher compared with controls in all groups except in the benign bladder lesions group. It was noticed that a progressive increase in the mean value of serum LnP1 accompanied a change in the grade of the disease. Tissue detection for LnP1 by immunoperoxidase revealed a continuous intact basement membrane [BM]. BM loss was directly proportional to the grade of bladder carcinoma. Serum Fn values revealed no significant difference compared with controls in all the studied groups. Fn immunoperoxidase staining showed negative or weak results in all the studied groups. Serum LnP1 may be a diagnostic and prognostic parameter in TCC after the exclusion of other diseases that increase its expression. It may also be used for monitoring and detecting the recurrence