Serum angiopoietin-1 as a prognostic marker in resected early stage lung cancer

Purpose: We evaluated the clinical significance of angiopoietins and vascular endothelial growth factor (VEGF) in patients with resected early stage lung cancer. Patients and methods: The study enrolled 101 patients with completely resected non-small cell lung cancer (NSCLC) of stage I or II, along with 70 healthy volunteers. Serum concentrations of angiopoietin-1, angiopoietin-2, and VEGF were measured with an ELISA. Immunohistochemical expression of angiopoietin-1 was compared with the microvessel density on the lung cancer tissues. Results: The patients had lower serum angiopoietin-1 (32.1 +/- 9.9 ng/mL vs. 39.0 +/- 10.8 ng/mL, p < 0.001), higher angiopoietin-2 (1949.2 +/- 1099.4 pg/mL vs. 1498.6 +/- 650.0 pg/mL, p < 0.01), and higher VEGF (565.1 +/- 406.3 pg/mL vs. 404.6 +/- 254.8 pg/ml, p < 0.01) levels than the controls. The angiopoietin-2 level was higher in stage II than in stage I patients (p<0.05). The levels of angiopoietin-1 (r=0.28) and angiopoietin-2 (r = 0.36) each correlated with the VEGF level. Patients with a higher level of angiopoietin-1 (>= 31.2 ng/mL) had better disease-specific and relapse-free survival than those with a lower angiopoietin-1 level (<31.2 ng/mL). Angiopoietin-1 expression negatively correlated with the microvessel density. Conclusion: Serum angiopoietin-1 is a potential marker for predicting postoperative survival and recurrence in patients with early stage NSCLC. (C) 2009 Elsevier Ireland Ltd. All rights reserved.