Expressions of Angiogenic Markers and Apoptotic Markers in Soft Tissue Sarcoma
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Date
2013
Authors
Baharuddin Salleh
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Abstract
Introduction: For tumor development and progression, angiogenesis and apoptosis play a
crucial role. No study so far has tried to associate these two activities in tumor cells as well as
correlation of both activities in the tumor and the endothelial cells.
Aim: This study was designed to compare the expression of anti-apoptotic Bcl-2 and proapoptotic
Bax on the tumor cells and the endothelial cell of blood vessels supplying the tumor in
soft tissue sarcoma. In relation to that, we also tried to associate the relationship between
apoptotic and angiogenic activity in soft tissue sarcoma.
Methodology: A cross sectional study was conducted from April 2009 to October 2010. 101
cases of soft tissue sarcoma consisted of liposarcom (37), MFH (19), synovial sarcoma (6), Sl.t-P.;)
leiomyosarcoma (14), MPNST (7), fibrosarcoma (9) and rhabdomyosarcoma (9) were included
in this study. Tissue sections that were retrieved from archieved tissue blocks were stained with
immunohistochemical stain for Bcl-2, Bax and VEGF protein.
Results: Higher expression of Bax in tumor cells (54.5%) was seen compared to expression of
Bcl-2 (44.6%) though statistically not significant. There were also significant association
between the expression of Bcl-2 and Bax in tumor cells with endothelial cells (p<0.001). With
tumor characteristics, the only significant association in our study was the expression ofBcl-2 in
tumor cells with tumor histologic subtypes. In this study, we were able to demonstrate that the
expression ofVEGF is higher with weak expression ofBax in soft tissue sarcoma. However, the
expression of VEGF was not associated with expression of Bcl-2, tumor location, depth, size,
margin, lymph nodes metastases and histologic subtypes.
Discussion: This study supports the role of endothelial cells in survival and regression of tumor
cells in tumorogenesis. Thus, the inhibition of endothelial cells survival factor or activation of
endothelial cells death is a promising prospect as a candidate for tumor therapy. All the proteins
used in this study might be potential as a useful marker for diagnosis of specific histologic
subtypes especially Bcl-2 since there is diversity in expression amongst the various histologic
subtypes in STS. An increase in angiogenic activity may inhibit apoptotic tumor cells death
which leads to cell proliferation. However, the angiogenic activity was independent of antiapoptotic
activities. A better understanding of their relations probably provides the basis for
more rational cancer therapies in the future.