Tissue expression of VEGF in cervical intraepithelial neoplasia and cervical cancer.

PURPOSE To examine the expression of vascular endothelial growth factor (VEGF) in the cervical tissue of individuals divided into the control group (normal cervix), group A (HSIL lesions), and group B (cervical cancer, FIGO stage I-IIA). Analyzed was also the expression of VEGF between groups and subgroups in group A and B. The expression of VEGF was also compared with histopathological parameters in group B. METHODS Examined was the histopathological material taken from 109 operated patients. The patients were divided into 3 groups based on the definitive histopathological findings: control group (30 patients), group A (33 patients), and group B (46 patients). Immunohistochemistry was performed to examine the expression of VEGF. RESULTS The expression of VEGF was negative in the control group, while in 11 patients (33.33%) from group A and 28 patients (60.87%) from group B it was significantly different (p<0.05) compared to the control group. There was neither statistically significant difference in the expression of VEGF in group A regarding the type of intraepithelial lesion, nor in group B regarding the FIGO disease stage (p>0.05). In patients with poor histopathological prognostic parameters such as tumor diameter ≥ 2 cm (24/46), depth of stromal invasion ≥ 10 mm (32/46), positive lymph nodes (17/46), and with infiltration of the uterine body (11/46) a statistically significant difference was confirmed regarding the expression of VEGF. CONCLUSION The increased VEGF expression in groups A and B compared with the control group indicated the importance of VEGF as a proangiogenic factor in neoangiogenesis in precancerous and cancerous changes in the cervix. The frequent expression of VEGF in the subgroup of patients with poor histopathological prognostic factors (group B) indicated the importance of the activity of proangiogenic factors in the process of cervical cancer neoangiogenesis. Further investigations should be aimed at these markers as prognostic factors in the high risk group of patients with cervical cancer who should receive adjuvant therapy after radical operation and consider using antiangiogenic drugs as part of adjuvant treatment.