Expressions of Angiogenic Markers and Apoptotic Markers in Soft Tissue Sarcoma

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Date
2013
Authors
Baharuddin Salleh
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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.
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