RESUMO
Angiogenesis is essential for tumor growth and progression and is mediated by positive and negative regulators of vessel growth. Since angiogenic mediators found in patient serum have been postulated to reflect the angiogenic potential of a malignant tumor, we investigated the angiogenic stimulators activity such as [vascular endothelial growth factor [VEGF], matrix metalloproteinases [MMPs]] and angiogenesis inhibitor such as endostatin in the serum of patients with primary transitional cell carcinoma of the bladder and to evaluate their clinical prognostic application. The present work was conducted on twenty four male patients pathologically proved carcinoma of the urinary bladder; 2 patients had superficial bladder cancer, 14 patients had localized invasive bladder cancer and 8 patients had distant metastasis. The pathologic grade was grade I in 8 patients, grade II in 9 patients, and grade III in 7 patients. In addition twelve normal healthy male subjects of matched age and sex were included as control group. The serum VEGF, MMP-9 and endostatin levels were significantly greater in all patients with bladder cancer than in the healthy controls [p<0.001]. When compared according to tumor stage, the distant metastatic group had significantly greater levels of serum VEGF, MMP-9 and endostatin than the localized invasive group [without distant metastasis]. The levels of the three parameters were significantly greater in patients with high-grade tumors [G3] than in patients with low-grade tumors [Gl and G2] [p<0.001], but no statistically significant difference was found between Gl and G2. A significant positive correlation between endostatin and each of VEGF and MMP-9 [r= 0.63; p<0.01 and r = 0.65;p<0.01 respectively]. The previous results denote that serum levels of endostatin, MMP-9 and VEGF were elevated in patients with transitional cell carcinoma of the bladder. The elevation was associated with the stage and grade of bladder cancer. Thus, elevation of serum levels of endostatin, MMP-9 and VEGF might be considered as indicators of tumor invasion and metastasis in the future