Assessment of angiogenic factor, vascular endothelial growth factor, serum and urine level changes in superficial bladder tumor immunotherapy by intravesical Bacillus Calmette-Guerin

Bladder tumor is one of the most common genitourinary tumors. Management of non-muscle invasive [NMI] bladder tumors is primarily by transurethral resection [TURBT] followed by intravesical immunotherapy or chemotherapy. Bacillus Calmette-Guerin [BCG] is the most effective adjuvant therapy in NMI bladder tumor. Since angiogenesis is an essential factor in solid tumor progression and vascular endothelial growth factor [VEGF] is an important factor in angiogenesis, the aim of this study is the assessment of angiogenic factor, VEGF, serum and urine level changes in superficial bladder tumor immunotherapy by intravesical BCG. A total of 23 patients with bladder transitional cell carcinoma [TCC] in stage Ta/T1 or carcinoma insitu [CIS], low or high grade, which passed a 2-4 week period from TURBT participated in this study. Blood and urine samples were obtained at first and sixth sessions before instillation of BCG. Enzyme-linked immunosorbent assay [ELISA] method was used to obtain VEGF level in samples. Urine and serum VEGF levels did not change significantly before and after BCG therapy. Changes in VEGF level were significantly different neither in low grade against high grade tumors nor in stage T1 against stage Ta tumors. A significant difference in VEGF level was seen between low grade and high grade tumors in serum after BCG therapy [P=0.007]; but not in urine samples. Although intravesical BCG possesses anti-angiogenic activity, it seems that it exerts its effect through pathways other than VEGF, especially in low grade tumors

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

Vascular cell adhesion molecule-1, E-selectin and von willebrand factor: Role as surrogate markers of angiogenesis in breast cancer

Angiogenesis, the development of new blood vessels from pre-existing vasculature, is a prerequisite for tumor growth and metastasis in breast cancer. Surrogate markers for angiogenesis would be useful for studying the effectiveness of antiangiogenesis drugs. We examined the potential of three glycoproteins: vascular cell adhesion molecule-1 [VCAM-1], endothelial selectin [E-Selectin], and von Will brand factor [vWF], to serve as markers for angiogenesis. Serum levels of VCAM-1, E-selectin and plasma vWF levels were measured by enzyme-linked immunosorbent assay in 54 women with different stages [1-IV] of breast cancer [12 women in stage 1, 16 in stage 11, I4 in stage III and 12 in stage IV]. Their ages ranged from 25-70 years. To investigate whether the concentration of these activated endothelial cell molecules are associated with breast cancer, the serum levels of soluble VCAM-1, E-selectin and plasma levels of vWF in women with breast cancer were compared with those of22 healthy age-matched control women, we also examined whether levels of VCAM-1, E-selectin or vWF are associated with tumor progression and stage of breast cancer [early and advanced breast cancer]. The results revealed that levels of VCAM-1, E-selectin and vWF are elevated in breast cancer women, even in early stages when compared with control women. Although plasma vWF and serum VCAM-1 levels were significantly elevated in advanced stages than early stages of breast cancer with a positive correlation with disease stage, E-selectin did not show a statistical difference between different stages of breast cancer. vWF, which is released by all endothelial cells, would be a pan-endothelial marker that would not accurately report angiogenesis and Serum soluble VCAM-1 can, be considered as an accurate marker of tumor angiogenesis in breast cancer

Serum angiogenin level in congenital heart diseases

Abnormal angiogenesis is reported in patients with con-heart diseases [CHD]. Angiogenic growth factors play an important role in the regulation of angiogenesis. This study was done to assess angiogenin [ANG] levels in children with CHD, its correlation with degree of hypoxaemia and its relation to the development of pulmonary hypertension [PH]. Serum ANG level was assessed by sandwich .enzyme immunoassay technique in 36 children with cyanotic congenital, heart diseases [CCHD] and in 35 children with acyanotic congenital heart diseases [ACHD]. Both groups were compared to 12 healthy controls of matched age and sex. CCHD patients had higher serum ANG levels compared to ACHD [177.8 +/- 53.7 Vs 149.4 . +/- 51.2 ng/ml, P=0.02] and controls m8 +/- 53.7 Vs 114.8 +/- 51.8 ng/ml, P 0.002]. A1VG was negatively correlated with pO2 and O2 saturation [r =-0.46, p=0.004 and r =-0.403, p 0.015; respectively]. AATG level in ACHD was not significantly different from controls [149.4 +/- 51.2 Vs 114.8 +/- 51.8 ng/ml, P=0.06]. In ACHD, patients with PH had significantly elevated ANG levels when compared to without PH [188.9 +/- 48,7 Vs 137.7 . +/- 46.6 ng/ml, P=0.011 and to controls [1 88.9 +/- 48.7 V 114.8 +/- 51.8 ng/ml, P=0.005]. Increased ANG in CCHD-secondary to hypoxemia-may responsible for abnormal angiogenesis in these patients. Increased ANG levels in ACHD patients with PH may be a compensatory mechanism aiming for neovasculrization distal to the site of pulmonary vascular obstruction