Determination Of Prognostic Markers For Cervical Cancer
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Date
2008-03
Authors
Ahmad, Rahmatul Wahida
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Biomolecular factors could possibly improve the prediction of prognosis and
diagnosis in cancer. Understanding specific molecular pathways could possibly
shed some light in improving therapeutic modalities so that the treatment plan can
be modified to suit individual cases. Various markers including factor VIII related
antigen (MVD), Cyclooxygenase-2 (COX-2), E-cadherin, human telomerase
reverse transcriptase (hTERT) and insulin like growth factor receptor (IGF-R) have
been shown to play important roles in carcinogenesis and in predicting the
prognosis of cervical cancer. Proliferation of tumor cells is uncontrolled, excessive
and requires less growth factor since tumor cells have aberrant expression of IGFR.
However, tumor cells cannot grow more than 1-10mm3 unless it is vascularised
through angiogenesis by the formation of microvessels. Furthermore high
expression of COX-2 suppress apoptosis, promote angiogenesis and tumor
invasion. Malignant tumor cells have high metastatic potential because the cells
are less adherent to each other as a result of decreased expression of E-cadherin.
Cancer cells also do not undergo replicative senescence during each cell division
because the hTERT enzyme synthesizes new telomerase and prevent apoptosis.
This retrospective study was done among normal cervix, cervical intraepithelial
neoplasia (CIN) and squamous cell carcinoma (SCC) of cervix which have been
histopathologically diagnosed from year 1998 to 2003 in HUSM. All samples were
subjected to immunohistochemistry approach to quantify the microvessel density
(MVD) and to estimate the percentage of the expression of COX-2, E-cadherin,
hTERT and IGF-R. Our results revealed that there were significantly increased
expression of MVD, COX-2, hTERT and IGF-R as the disease become more
cancerous (p<0.001). However, decreased expression of E-cadherin were seen in
SCC samples compared to normal and CIN samples (p<0.001). MVD expression
has been shown to be the most related with all clinical and clinicopathological
parameters including lymph node metastasis (p=0.005), parametrial involvement
(p=0.003), vascular space involvement (p=0.004), deep stromal invasion (p=0.003)
and tumor differentiation (p=0.002). While COX-2 protein expression showed a
significant correlation with lymph node metastasis (p=0.006), parametrial
involvement (p=0.004) and tumor differentiation status (p= 0.001).
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Keywords
Biomolecular factors could possibly improve the , prediction of prognosis and diagnosis in cancer