THE INTERPLAY BETWEEN C-MYCONCOGENE EXPRESSION AND CIRCULATING VASCULAR ENDOTHELIAL GROWTH FACTOR, ITS ANTAGONIST RECEPTOR, FUNS-LIKE TYROSINE KINASE 1 IN DIFFUSE LARGE B CELL LYMPHOMA: RELATIONSHIP TO PATIENT OUTCOME

Aim: is to assess the relation between c-Myc oncogene expression and angiogenic factors namely vascular endothelial growth factor (VEGF), funs-like tyrosine kinase 1(Flt-1) in patients with diffuse large B cell lymphoma (DLBCL) and their impact on the patient outcome. Methods: Forty Five DLBCL patients beside 10 normal controls were included. c-Myc oncoprotein was assessed by immunohistochemistry and sVEGF, and sFlt-1 were assessed by immunosorbent assay. Results: c-Myc over-expression was detected in 66.6% of DLBCL. The DLBCL patient group with positive c-Myc overexpression showed significantly higher sVEGF and significantly decreased sFlt-1 as compared to group with negative c-Myc over-expression (P=0.000, 0.009 respectively). sVEGF was positively correlated to sLDH and .v./32 microglobulin (r =0.6, p=0.000, r =0.69, P= 0.000) respectively. The non-survived DLBCL group showed significantly higher expression of c-Myc , high concentration of sVEGF and lower concentration in sFlt-1 as compared to the living group (P=0.000for all). Conclusion: These findings confirm the in vitro based suggestion that c-Myc over-expression orchestrate the angiogenic switch necessary for tumor progression. c-Myc over-expression, elevated sVEGF, and normal sFlt-1 at diagnosis are poor prognostic markers in DLBCL patients