Serum bone TRAP 5b and ICTP as prognostic markers in bone metastases from primary breast cancer

Bone is one of the earliest and most common sites for breast cancer metastasis. One-third of cancer patients will have metastases of their primary tumor to bone. The incidence ofbone metastases from primary breast cancer is approximately 13%. Bone marker measurements are noninvasive, inexpensive, and can be repeated often. Markers are derived from both cortical and trabecular bone and reflect the metabolic activity of the entire skeleton. The aim of this work was to determine serum level of Tartrate Resistant Acid Phosphatase 5b [TRAP 5b], Carboxy terminal telopeptide of type I collagen [ICTP] and CA15.3 pre-and post-operatively in patients with primary breast, cancer to asses their values as prognostic factors for the subsequent metastatic disease. Serum samples were collected from 41 females [31 patients with primary breast cancer and 10 normal healthy volunteers]. three samples were collected from patients before surgery, after 10 and 20 months from surgery. Serum TRAP 5b, ICTP a"dCA15,3 were detected by using EIA techniques. Preoperative serum ICTP concentrations >4.6ug/l [2+2SD]. were highly predictive for bone as site of metastases and higher risk of death by three times than those with preoperative serum ICTP concentrations <4.6 micro g/l While after 10 months from surgery. Bone TRAP 5b activity >5.4U/Lwas significantly correlated with poor prognosis for breast cancer and shorter 'wall survival. Serum ICTP concentrations in bone metastases sub. group, after 10 months from surgery [before reflect any Metastasis], were significantly increased from control group. Serum ICTP. TRAP'5b and CA15-3 levels were elevated in bone metastatic patients after 20 months from surgery [bone mciastases had been already diagnosed]. ICTP and TRAP 5b could be useful markers in predicting bone meiastases and might identify patients who would need uliiesorptive treatment in addition to chemotherapy.

Correlation between extent of tumor vascularization, prognosis and hematogenous metastases in gastric carcinoma using vascular endothelial growth factor [VEGF] and Von-Willebrand factor

Angiogenesis has a crucial importance for tumor growth and development of metastasis. This study aimed to evaluate angiogenesis. Microvessel density [MVD] was counted by staining endothelial cells immunohistochemically using anti von Willebrand vWF [factor VIII] antibody as well as vascular endothelial growth factor [VEGF], a known endothelial proliferative and mitogenic marker. Thirty prospective cases [24 cases of adenocarcinoma and 6 of diffuse infiltrating tumors] were enrolled in this study. Then, four cases were excluded from the study because they had inoperable tumors. Thus, a total of 26 patients was studied histologically, immunohistochemically and followed up for a period ranging from 6-30 months [median 12 months]. The immunohistochemical results of these biomarkers were correlated with standard prognostic factors [tumor grade, stage and lymph node metastasis] as well as overall survival period. It was found that MVD was significantly increased in deep advanced tumors and in the presence of nodal metastasis. However, VEGF positivity was demonstrated in only 46% of the cases and was not correlated with the clinicopathologic parameters. The MVD for cases that developed hematogenous metastasis was significantly higher than those having non metastatic tumors. Also, MVD was correlated with a relatively higher survival rates in favor of the hypovascular group