In cervical cancer, Wiggins et al. (1995) analyzed immunohistochemical staining for factor VIII-related antigen in cervical cone biopsies or hysterectomy specimens from 34 patients with squamous cell cervical cancer. These authors concluded that angiogenesis may be a predictor for recurrent disease.20 Throughout the recent decade an increasing volume of data has accumulated regarding angiogenesis in cervical cancer. However, the evidence for a correlation between angiogenesis and prognosis in cervical cancer is quite conflicting, and it is very difficult to evaluate the role of angiogenesis as a prognostic factor in these studies because of the small sample size, and the marked heterogeneity of stage and treatment modality.19-25 For early stage cervical cancer patients, Bremer et al. demonstrated that microvessel density is an independent prognostic parameter for disease-free survival.21 Obermair et al. also found that high microvessel density adversely influences patients survival in clinical stage 1b cervical cancer.19 The current study shows that angiogenesis, expressed as microvessel density at or above 9 vessels per high power field, is an independent prognostic parameter for recurrence-free survival, which is similar to previous studies as shown in Table 5.19-22,31 However, a study by Lee (2002) showed no correlation between angiogenesis, expressed as vascular endothelial growth factor (VEGF) expression and survival.25 The difference may explained by VEGF expression alone not being representative of the complex processes of tumor angiogenesis.25,32
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Posted by : 11 , Date : 2007-03-27 , Time : 22:29:43 , From IP : 172.29.7.127
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