Evaluation of serum level of some angiogenic factors in non hodgkin's lymphoma

Background: Angiogenesis is a prerequisite for growth of tumors whether solid or liquid tumors. The process of angiogenesis is very complex and tightly regulated by positive and negative regulatory factors, the precise role of these processes in lymphoma pathogenesis is under active investigation. This work aimed at assessing serum levels of certain angiogenic factors in cases of non Hodgkin's lymphoma (NHL) whether newly diagnosed or relapsed and there correlations to disease progression and staging. Methods: Serum levels of certain positive regulatory factors for angiogenisis namely "Angiogenin, Nitric oxide, Copper", and Zinc as a negative regulatory factor were assayed, and Copper / zinc ratio were determined in 57 patients of NHL classified into four groups according to the disease stage investigated before the start of chemotherapy and 20 healthy controls. Result: Patients in 1 group (stage I and II) showed significant elevation in serum levels of angiogenin, copper, and insignificant changes occurred in serum levels of zinc, nitric oxide and in copper zinc ratio in comparison with the control group. On the other hand; patients in 2 group (stage III) and 3 group (stage IV) showed highly significant increase in serum levels of copper and copper zinc ratio; while insignificant changes occurred in serum levels of angiogenin and nitric oxide. Conversely, highly significant decrease occurred in serum levels of zinc in 2 group only. Patients in 4 group (relapsed cases) showed highly significant increase in serum levels of copper, significant increase in serum levels of angiogenin and in copper/inc ratio, while insignificant changes occurred in serum levels of zinc, and nitric oxide. The comparison between different patients groups revealed no significant differences in all special investigations except for zinc where there was a significant lower level of zinc in 2 group than 1 group, and for copper and copper/zinc ratio; there were significant rise of each in 4thgroup in comparison to 1 group. Conclusion: The serum angiogenin and copper levels may play an important role in early detection of NHL as it increased significantly in early stages, the highest levels were found in advanced cases together with low zinc level suggesting their role in follow up of NHL together with consideration of copper /zinc ratio while limited role of nitric oxid had been observed.