Levels of endostatin and some angiogenic indices in both sera and pleural fluids of patients with small cell lung cancer

ABSTRACT

Angiogenesis plays an important role in growth, progression and metastasis of neoplasms. Levels of vascular endothelial growth factor [VEGF], transforming growth factor-beta1 [TGF-beta 1] and basic fibroblast growth factor [bFGF] [as angiogenic factors] and endostatin [as anti-angiogenic factor] were evaluated in sera of 30 male patients with non small cell lung cancer [NSCLC]. Their ages ranged from 36 to 70 years, average 59.3 years and 10 age and sex matched healthy controls. Pleural fluid levels of these cytokines were estimated in 18 out of 30 cancer patients as well as 10 patients with congestive heart failure pleural effusion as a control group. The present study was designed to determine whether these indices could be used as diagnostic tools for lung cancer and to evaluate their correlation to the stage of the disease. Lung cancer patients showed significant [P<0.001 and P<0.05] increased levels of the studied bioindices in both serum and pleural fluid compared with control subjects. There was no significant difference in the serum and pleural fluid levels of these cytokines between the different histological types of lung cancer. Lung cancer patients with advanced stages [n =24] showed significantly higher serum [P<0.001] levels of angiogenic factors and endostatin compared with those with early stages [n=6]. In patients with lung cancer, a significant positive correlation was found between serum levels of endostatin and each of VEGF [r = 0.58, P<0.0001], TGF-beta1 [r = 0.52, P<0.01]. and bFGF [r = 0.4, P<0.01]. A significant positive correlation between serum VEGF and TGF-beta1 [r = 0.45, P<0. 01] was found in patients with advanced lung cancer. Regarding Pleural effusion, there were significant positive correlations between levels of endostatin and each of VEGF [r = 0.44, P<0.0001], TGF-beta 1 [r = 0.43, P<0.01] and bFGF [r = 0.46, P<0.01]. Similarly, a significant positive correlation between VEGF and TGF-beta 1 [r = 0.45, P<0.01] was found. In conclusion: measurement of VEGF, TGF-beta 1 and bFGF [as angiogenic factors] and endostatin [as anti-angiogenic factor] could be used as tumor markers in NSCLC. Their serum and pleural fluid levels are correlated to disease severity rather than its pathological types. The endogenous pro- and anti-angiogenic factors reveal the complexity of the homeostatic system controlling angiogenesis. Further studies are recommended to follow up these factors in different clinical states and correlate their levels with prognosis