RESUMEN
Objective: To investigate the effect of neoadjuvant chemotherapy (NACT) on microvessel density (MVD)/ lymphatic microvessel density (LMVD) in locally advanced uterine cervical cancer and its clinical impact. Methods: Seventy patients with IB2-IIB cervical cancer were recruited, and the surgical specimens of cervical cancer tissues were collected. The MVD and LMVD of cervical cancer were examined by immunohistochemistry, and the relationship between clinical response of NACT and the clinicopathological characteristics was analyzed. Results: The levels of MVD and LMVD in cervical cancer tissues were significantly higher than those in the normal cervical tissues (P<0.001; P=0.028). The MVD was related to the depth of cancer invasion (P=0.039), and the LMVD was related to the level of serum squamous cell carcinoma antigen (SCCAg) and the lymph node metastasis (P=0.017; P=0.049). The level of MVD was significantly decreased after NACT as compared with that before NACT (P=0.019). As compared with the levels of MVD and LMVD before NACT, these levels were both decreased after NACT (P=0.019; P=0.176). The overall response rate of NACT was 70.0% (49/70), and the complete response rate was 21.4% (15/70). Multivariate analysis displayed that the depth of cancer invasion was an independent factor related to the response of NACT (P=0.018, odds ratio = 0.169). Conclusion: NACT can be helpful to reduce the level of MVD and the volume of tumor in locally advanced cervical cancer. Copyright© 2011 by TUMOR.
RESUMEN
<p><b>BACKGROUND AND OBJECTIVE</b>In the past decade, no remarkable improvement has been made in the 5-year survival of cervical cancer patients. This study was to explore the influence of lymph vascular space invasion (LVSI) on the prognosis of patients with early-stage cervical squamous cell carcinoma.</p><p><b>METHODS</b>A total of 111 eligible patients with FIGO stage IB and IIA cervical squamous cell carcinoma underwent radical hysterectomy and pelvic lymphadenectomy at Sun Yat-sen University Cancer Center between January 1995 and December 2002. The histopathological slides of the 111 patients were reviewed by a senior gynecological pathologist. LVSI, invasion depth, tumor differentiation and lymph node metastasis were evaluated.</p><p><b>RESULTS</b>LVSI was present in 62 patients. The univariate analysis showed that the risk factors of overall survival (OS) included positive LVSI (P = 0.019) and lymph node metastasis (P = 0.002), while the risk factors of progression-free survival (PFS) included LVSI (P = 0.029), lymph node metastasis (P = 0.002), SccAg value (P = 0.018), invasion depth (P = 0.022) and positive surgical margin (P = 0.002). The multivariate analysis showed that lymph node metastasis was the independent prognostic factor of OS (P = 0.015), while lymph node metastasis and positive surgical margin were the independent factors of PFS (P = 0.006, P = 0.006). LVSI was correlated with lymph node metastasis (P = 0.011).</p><p><b>CONCLUSION</b>Whether LVSI is an independent prognostic factor of early-stage cervical squamous cell carcinoma cannot be determined currently while LVSI is a risk factor of metastasis and relapse.</p>