title: Clinical significance of vascular endothelial growth factor (VEGF) in sera of patients with pediatric malignancies.
abstract: BACKGROUND
  Angiogenesis is essential for solid tumor growth. It is induced by tumor cells through stimulatory angiogenic peptides, one such peptide is vascular endothelial growth factor (VEGF).
  
  
  OBJECTIVE
  The ultimate aim of the work is to investigate the possible role of VEGF as an early biomolecule involved in the progression of pediatric malignant tumors with high metastatic potential.
  
  
  METHODS
  Forty-five pediatric patients were studied. They included four groups with malignant solid tumors suffering from Ewing's sarcoma, osteosarcoma, neuroblastoma and rhabdomyosarcoma. In addition, a healthy control group including fifteen age and sex matched children was included in the study. Serum VEGF levels were determined by ELISA technique.
  
  
  RESULTS
  The level of VEGF was significantly higher in all types of solid tumors compared to normal healthy children. The mean values obtained for patients and controls were 429.44 +/- 258.55 pg/ml and 79.36 +/- 63.81 pg/ml, respectively. No significant difference was detected in the level of VEGF among males and females. Also, no statistically significant difference was detected among the different types of malignant tumors. However, a marked significant difference was elucidated between metastatic and non-metastatic cancer patients, the values recorded were 753.33 +/- 173.64 pg/ml and 267.5 +/- 75.54 pg/ml, respectively (p < 0.001). Furthermore the results showed that 207 pg/ml of serum level of VEGF is the optimal cut-off value (mean +/- 2 SD of control) with sensitivity of 87% and specificity of 100%. Using the receiver operating characteristic (ROC) curve analysis,the area under the curve (0.917) indicated the validity of using serum VEGF level in the diagnosis of all different types of pediatric malignant solid tumors with high potentiality to metastasis.
  
  
  CONCLUSIONS
  VEGF is an angiogenic stimulatory peptide. Its serum level could be a reliable marker in assessing pediatric malignancies with high metastatic potentials.
authors.affiliation: Department of Cancer Biology, NCI, Cairo University.
authors.forename: Motawa E
authors.initials: ME
authors.lastname: El-Houseini
authors.forename: Samy Abdel-Fattah
authors.initials: SA
authors.lastname: Abdel-Azim
authors.forename: Ghassan Ibrahim
authors.initials: GI
authors.lastname: El-Desouky
authors.forename: Salah
authors.initials: S
authors.lastname: Abdel-Hady
authors.forename: Maha F
authors.initials: MF
authors.lastname: El-Hamad
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Kamel