Clinical and prognostic significance of circulating levels of angiopoietin-1 and angiopoietin-2 in hepatocellular carcinoma
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Roberto Carmagnani Pestana1, Manal M. Hassan2, Reham Abdel-Wahab3,7, Yehia I. Abugabal3, Lauren M. Girard3, Donghui Li3, Ping Chang3, Kanwal Raghav3, Jeff Morris4, Robert A. Wolff3, Asif Rashid5, Hesham M. Amin6 and Ahmed Kaseb3
1Department of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
2Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
3Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
4Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
5Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
6Department of Hemopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
7Department of Clinical Oncology, Assiut University Hospitals, Faculty of Medicine, Assiut, Egypt
Ahmed Kaseb, email: firstname.lastname@example.org
Manal M. Hassan, email: email@example.com
Keywords: angiogenesis; angiopoietin-1; angiopoietin-2; cirrhosis; hepatocellular carcinoma
Abbreviations: Ang-1: angiopoietin-1; Ang-2: angiopoietin-2; HCC: hepatocellular carcinoma; mAB: monoclonal antibody; OS: overall survival
Received: August 08, 2018 Accepted: November 16, 2018 Published: December 28, 2018
Angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) play critical roles in angiogenesis in hepatocellular carcinoma (HCC). In addition, recent data suggest that Ang-1/Ang-2 are involved in regulating the immune response. The aim of our study was to explore the clinical prognostic significance of plasma Ang-1 and Ang-2 in HCC. We prospectively enrolled and collected data and blood samples from 767 HCC patients treated at MD Anderson Cancer Center between 2001 and 2014. Controls consisted of cirrhotic patients (n = 75) and healthy volunteers (n = 200). The cutoff value was the median level of each angiogenic factor. Overall survival (OS) was estimated by Kaplan–Meier curves and compared by the log-rank test. Higher plasma Ang-2 was significantly associated with advanced clinicopathologic features of advanced HCC and lower OS. Median OS was 61.8 months (95% confidence interval [CI], 45.1–78.5 months) for low Ang-2 compared with 28.5 months (95% CI, 24.8–32.1 months) for high Ang-2 (p < 0.001). In contrast, higher Ang-1 was associated with longer OS. Median OS was 37.2 months (95% CI, 31.0–43.4 months) for high Ang-1 compared with 26.2 months (95% CI, 22.2–30.3 months) for those with low Ang-1 (p = 0.043). In conclusion, our findings indicate that plasma Ang-1 and Ang-2 levels are potential diagnostic and prognostic biomarkers in HCC.
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