title: Elevated serum endostatin is associated with poor outcome in patients with non-Hodgkin lymphoma.
abstract: BACKGROUND
  Endostatin is a cleaved fragment of collagen Type XVIII and has antiangiogenic activity. The clinical significance of circulating, soluble endostatin (S-endostatin) is not known.
  
  
  METHODS
  Pretreatment S-endostatin and serum vascular endothelial growth factor (S-VEGF) levels were measured in 143 patients with non-Hodgkin lymphoma (NHL) using competitive enzyme immunoassays and were compared with the levels from a control group (n = 24 participants).
  
  
  RESULTS
  S-endostatin levels varied widely from 4.5 ng/mL to 116 ng/mL (median, 29.6 ng/mL), and the median level was higher in patients with NHL compared with patients in the control group (16.4 ng/mL; P = 0.05). High S-endostatin levels were associated with advanced disease stage (P < 0.0001) and high serum VEGF levels at diagnosis (P = 0.017). The median 5-year survival rate for patients who had S-endostatin concentrations within the highest tertile (> 36.0 ng/mL) was only 34% compared with 57% in patients who had lower S-endostatin levels (P = 0.019). A high S-endostatin level also was associated with a poor outcome in patients with large cell diffuse and immunoblastic lymphoma, which was the largest subgroup within the series (n = 60 patients). Patients who had high pretreatment levels of both S-VEGF and S-endostatin had particularly poor outcomes. High S-endostatin levels had an independent, adverse influence on survival it was entered as a factor into a multivariate analysis together with the factors included in the International Prognostic Index (relative risk, 1.80; 95% confidence interval, 1.08-2.98; P = 0.0024).
  
  
  CONCLUSIONS
  High pretreatment levels of S-endostatin are associated with high serum VEGF levels and poor survival in patients with NHL. Prospective studies are warranted to establish the clinical value of longitudinal S-endostatin measurements.
authors.affiliation: Department of Oncology, Helsinki University Central Hospital, Finland. petri.bono@hus.fi
authors.forename: Petri
authors.initials: P
authors.lastname: Bono
authors.forename: Lasse
authors.initials: L
authors.lastname: Teerenhovi
authors.forename: Heikki
authors.initials: H
authors.lastname: Joensuu
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D003094:Collagen / Q000097:blood*; D043170:Collagen Type XVIII; D043169:Endostatins; D016228:Endothelial Growth Factors / Q000097:blood; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008222:Lymphokines / Q000097:blood; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood / Q000175:diagnosis; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
chemical_list: D014408:Biomarkers, Tumor; D043170:Collagen Type XVIII; D043169:Endostatins; D016228:Endothelial Growth Factors; D036341:Intercellular Signaling Peptides and Proteins; D008222:Lymphokines; D010446:Peptide Fragments; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D003094:Collagen; D007770:L-Lactate Dehydrogenase