Clinical significance of anigogenic marker in Egyptian bladder cancer patients

ABSTRACT

Vascular Endothelial growth factor [VEGF] is a principle growth factor mediating angiogenesis. The high expression of VEOF within bladder tumors is associated with a poor prognosis. We determined tissue, plasma and urinary levels of VEGF in patients with bladder cancer to study their correlation with the classical clinicopathological factors and to assess its potential role in the evaluation of bladder cancer patients. Materials and VEGF was measured by enzymeimmunoassay in the tissue, plasma and urine of 100 bladder cancer patients and in corresponding 40 healthy volunteers. Tumor tissue samples were standardized to the protein content and urine samples were normalized for creatinine content. Tissue, plasma and urinary VEGF levels were significantly elevated in bladder cancer patients compared to healthy controls [p < 0.001]. The highest VEGF levels were noted in patients with invasive and poorly differentiated bladder cancer compared to those with superficial and well or moderately differentiated individuals followed by healthy controls. Similarly, we detected the same observation in patients with lymph node metastases signifying that VEGF increases with tumor progression. Also, VEGF levels for schistosomal bladder cancer patients were elevated compared to non-schistosomal patients [although they were insignificantly different] and healthy controls as they correlated significantly together suggesting that bilharziasis may participate in angiogenie switch. VEGF sensitivity was superior to urine cytology and combined sensitivity between them was the highest [100%] when urine cytology combined with plasma or urinary VEGE Tissue, plasma and urinary VEGF were significantly correlated together implying that the tumor is the source of plasma and urinary VEGF. Our study demonstrates that strongly expressed VEGF may be relevant for diagnosis of bladder cancer patients, and it is implicated in the pathogenesis of bladder cancer progression. Quantification of urinary VEGF may provide a novel noninvasive marker for the early detection of bladder cancer as well a therapy target