ANGIOGENESIS IN CERVICAL NEOPLASIA - MICROVESSEL QUANTITATION IN PRECANCEROUS LESIONS AND INVASIVE CARCINOMAS WITH CLINICOPATHOLOGICAL CORRELATIONS

Recently, angiogenic properties have been shown in preinvasive cervica l lesions. Our goal was to determine the angiogenesis in cervical intr aepithelial neoplasia (GIN) and the relationship between microvessel c ounts, histopathological parameters, and clinical outcome in invasive cervical carcinoma. One hundred thirty-eight cervical specimens were e valuated; among these 20 were designated normal epithelium, 20 low-gra de GIN, 40 high-grade CIN, and 58 invasive carcinoma. Histological sec tions immunostained for CD31 were quantitatively evaluated for microve ssel density. The tumor proliferation rate was determined by the Ki-67 Labeling Index. Comparison of microvessel counts from normal epitheli um with those from CIN and invasive carcinoma showed significant incre ases in precancerous lesions and invasive cancer (P < 0.0001). Microve ssel density was found to be associated with the overall survival in w omen,vith invasive carcinoma (P < 0.01). There was a significant corre lation of microvessel density (P < 0.05) with relapse-free survival in patients with regional lymph node metastasis. A Cox stepwise regressi on analysis revealed microvessel density, together with depth of invas ion, regional lymph node status, and vascular invasion, to be a strong independent prognostic indicator for overall survival in patients wit h clinical stage IB cervical carcinoma. (C) 1997 Academic Press.