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Endocrine-Related Cancer 16 (3) 967 -976     DOI: 10.1677/ERC-09-0089
Copyright © 2009 by the Society for Endocrinology
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Circulating angiopoietin-2 is elevated in patients with neuroendocrine tumours and correlates with disease burden and prognosis

 R Srirajaskanthan, G Dancey1, A Hackshaw2, T Luong3, M E Caplin and T Meyer1

Neuroendocrine Tumour Unit, Royal Free Hospital, London NW3 2QG, UK
1 UCL Cancer Institute, University College London, 72 Huntley Street, London WC1E 6BT, UK
2 Cancer Research UK and UCL Cancer Trials Centre, University College London, London W1T 4TJ, UK
3 Department of Histopathology, Royal Free Hospital, London NW3 2QG, UK

(Correspondence should be addressed to T Meyer; Email: t.meyer{at}ucl.ac.uk)

Angiogenesis is an essential process in the development and growth of tumours. There are a large number of angiogenic mediators including the angiopoietin (Ang) family and vascular endothelial growth factor, which play an important role in both physiological and pathological angiogenesis. This study examines serum levels of Ang-1 and Ang-2 in patients with neuroendocrine tumour (NET) compared healthy controls. ELISA for Ang-1 and Ang-2 was performed in 47 patients with histologically proven NETs and 44 healthy controls. Immunohistochemical staining for Ang-2 was performed in patients to demonstrate cellular location of Ang-2. Serum Ang-2 levels were significantly elevated in patients compared controls (median 4756 vs 2495 pg/ml, P<0.001), while there was no significant difference in Ang-1 levels. The ratio of Ang-2:Ang-1 was significantly elevated in patients compared controls (0.13 vs 0.066, P<0.001). Serum Ang-2 levels were significantly elevated in patients with distant metastases compared with those without metastasis (median 5080 vs 3360 pg/ml, P=0.01). There was also a significant increase between Ang-2 levels and volume of liver metastases (P=0.014). Time to disease progression was worse in patients with serum Ang-2 levels >4756 pg/ml (P=0.04). Serum Ang-2 but not Ang-1 is elevated in NET patients. Ang-2 may be a useful serum marker for monitoring and assessment of prognosis in patients with NETs.






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