Comparison of microvascular density in cervical carcinoma in relation to predictive pathohistological parameters

Abstract

Objective: The occurrence, development, invasion, and metastasis of tumors are closely linked to angiogenesis, which is reflected by tumor microvessel density. The aim is to analyze microvascular density (MVD) in the observed groups of patients with high grade squamos intraepithelial lesions (H-SIL), and cervical carcinoma, and to compare MVD in relation to the degree of tumor differentiation, size, presence of lymphovascular invasion and the presence of lymph node metastases. Materials and methods: The study was retrospective, conducted on histopathological samples of 109 patients who underwent hysterectomy with/without adnexectomy at the Oncology Institute of Vojvodina. Patients were divided into two groups depending on the histopathological results as follows: group A - patients with H-SIL, and group B with cervical cancer. The control group included surgically treated patiens with benign uterine diseases. Based on hematoxylin and eosin staining, representative sample was chosen for immunohistochemistry, and the analysis of CD34 antigen expression and measurement of MVD were done. Results: In order to subdivide groups according to the low (L) and high (H) MVD, in control group, group A, and B, with mean MVDs 2.2; 9.85 and 17.19, respectively, a cut-off values were determined. In the control group, LMVD 100% was measured in the all examined samples. There were 7 (21.21%) in group A and 29 patients (63.04%) in group B with HMVD. A statistically significant difference was confirmed by comparing HMVD and LMVD in cervical cancer patients with lymph nodes metastasis (p<0.029). In the subgroup of patients with other worse pathohistological prognostic factors, a tumor size greater than 2 cm, depth of stromal invasion ?10 mm, infiltration of ?isthmus? of the uterus, a difference with no statistical significance was confirmed. Conclusion: Invasive cervical cancers are characterised by a significantly higher mean values of microvascular density compared to H-SIL. Significantly more often, HMVD is associated with the presence of lymph node metastases and with histopathological parameters of poor prognosis in patients with cervical cancer.