Abstract
The determination of factors associated with progression of cervical cancer is important, both for a recurrence risk assessment and for determining optimal treatment tactics. Previously, we showed the prognostic value of different types of tumor microvessels (MVs) in gastric and breast cancer. The object of this research was to study the morphology and clinical significance of different tumor microvessels in early cervical cancer. A total of 65 archived paraffin blocks of patients with I-IIA stages of squamous cervical cancer were investigated. Samples were stained with Mayer hematoxylin and immunohistochemically using antibodies to CD34, podoplanin, HIF-1a, and Snail. The eight types of tumor MVs differed in morphology were identified. It was established that only the dilated capillaries (DСs) with weak expression of CD34, the contact type DCs, the capillaries in tumor solid component, and the lymphatic vessels in the lymphoid and polymorphic cell infiltrates of tumor stroma are associated with clinical and pathological characteristics of early cervical cancer. Preliminary results also suggest that a combination of fragmentation in tumor solid component and the contact type DCs may predict a recurrence of early cervical cancer. Given the small number of cervical cancer recurrences, the predictive significance of the described markers requires a more thorough examination.
Highlights
Cervical cancer is an urgent worldwide public health problem [1]
The assessment of the relapse risk in early cervical cancer is based mainly on the clinical characteristics of the disease, such as age, AfricanAmerican ethnicity, human papillomavirus 18 infection, histology, grade, deep cervical stromal invasion, tumor size over 2 cm, lymphovascular space invasion, nodal metastases, microscopic tumor in uterine parametrial tissues, positive surgical margins, and type of surgery [4,5,6,7]. e importance of such assessments is related to the requirement to select the patients in whom organ-preserving operations may be safe [4,5,6], as well as for the selection of Journal of Oncology patients requiring adjuvant therapy [8]
We have described five different types of tumor MVs and structures with endothelial lining: normal MVs, dilated capillaries (DCs), atypical dilated capillaries (ADCs), structures with partial endothelial lining, and the distinctive cellular structures in a loose finefibered connective tissue of the peritumoral stroma, in which the DCs with weak expression of cluster of differentiation 34 (CD34) were present
Summary
In 2018, about 570,000 cases of cervical cancer were identified, and 311,000 patients died from the disease. It ranks as the fourth most frequently diagnosed cancer and the fourth leading cause of cancer death in women [2, 3]. Cervical cancer is characterized by an aggressive course and the detection of this pathology at an early stage does not always guarantee a favorable result. In this regard, the determination of factors associated with the progression of cervical cancer is important, both for an accurate assessment of the relapse risk of the disease and for determining the optimal tactics for treatment. Given the risk of serious side effects from radiation therapy and chemotherapy, such studies are undoubtedly of interest [9,10,11,12,13]
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