VEGF-C level as a predictor of pelvic lymph node metastases of cervical cancer at early stage
DOI:
https://doi.org/10.13181/mji.v18i4.372Keywords:
cervical cancer, metastatis, VEGFAbstract
Aim Vascular endothelial growth factor (VEGF) works to stimulate angiogenesis and lymphogenesis which is one of the factors in the metastasis process. This study aimed to identify whether VEGF level could be used to predict metastasis into pelvic lymph node of stage IB-IIA cervical cancer.
Methods The study was case control study, a case (cervical cancer metastasis into pelvic lymph node), a control (cervical cancer without metastasis). Independent variables included primary lesion size, histological type, grade of cell differentiation, lymph vascular space involvement, and VEGF level. Dependent variable was metastasis into pelvic lymph node.
Results Based on cut-off point, VEGF-C serum level, i.e., 10,066.90 pg/ml, 11/47 patients or 23.41%, had the level above that value, and 10/11 of the group of patient or 90.91% were found to develop metastasis into pelvic lymph node. Sensitivity of the examination of VEGF-C level in relation to the risk for the incidence of lymph node in this study was 71.43%, with a specificity of 96.97%, positive predictive value (PPV) of 90.91%, and negative predictive value (NPV) of 88.89%.
Conclusion: VEGF-C level in the serum could be used to predict lymph node metastasis of stage IB-IIA cervical cancer, with a sensitivity of 71.43% and specificity of 96.97%. (Med J Indones 2009; 18: 257-61)
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References
DiSaia PJ, Creasman WT. Clinical Gynecologic Oncology. Sixth edition. Mosby Inc, Missouri.2002;53-112.
Sevin BU, Nadji M, Lampe BY, Hilsenbek S, Koechli OR, Averette HE. Prognostic factors of early stage cervical cancer treated by radical hysterectomy. Cancer. 1995;76:1978-86.
Pieterse QD, Trimbos JBMZ, Dijkman A, Creutzberg CL, Gaarentstroom KN, Peters AAW, Kenter GG. Postoperativeradiation therapy improves prognosis in patients with adverse risk factors in localized, early-stage cervical cancer : a retrospective comparative study. Int J Gynecol Cancer 2006;16:1112-8.
Micha JP, Goldstein BH, Rettenmaier MA, Brown JV, John CR, Markman M. Surgery alone or surgery with a combination radiation or chemoradiation of management of patients with bulky-stage IB2 cervical carcinoma. Int J Gynecol Cancer. 2006;16:1147-51.
Zola P, Landoni F, Torri W, Buda A, Mazzola S. Randomised controlled trial of adjuvant treatment in early cervical cancer. 13th International Meeting of ESGO, Brussel, 2003 April 6-10.
Kodama J, Seki N, Tokumo K, Hongo A, Miyagi Y, Yoshinouchi M, et al. Vascular endothelial growth factor is implicated in early invasion in cervical cancer. Euro J of Cancer.1999;35(3):485-9.
Lee KBM, Lee JM, Park CJ, Lee KB, Cho HY, Ha SY. Lymph node metastasis and lymph vascular space invasion in microinvasive squamous cell carcinoma of the uterine cervix. Int J Gyn Cancer.2006;16(3):1184-7.
Hashimoto I, Kodama J, Seki N, Hongo A, Yoshinouchi M, Okuda H, et al. Vascular endothelial growth factor-C expression and its relationship to pelvic lymph node status in invasive cervical cancer. British J of Cancer. 2001;85:93-7.
Detmar M, Hirakawa S. The formation of lymphatic vessel and its importance in the setting of malignancy. Th J of Exp Med.2002;196(6):713-8.
Pinedo HM, Slamon DJ. Translational Research: The role of VEGF in tumor angiogenesis. The Oncologist. 2000;5(1):1-2.
Stacker SA, Baldwin ME, Achen MG. The role of tumor lymphangiogenesis in metastatic spread. The Faseb J. 2002;16 July:922-34.
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