Macrophage infiltration and angiogenesis in cervical squamous cell carcinoma - clinicopathologic correlation

Background. The role of angiogenesis and inflammatory cell response in pred icting disease outcome was evaluated in various malignant tumors. However, the data relating to cervical cancer remains equivocal. This study evaluate s the prognostic significance of microvessel counts and peritumoral macroph age infiltrates in squamous cell carcinoma of the uterine cervix. Methods. Seventy-five cervical squamous cell carcinomas were stained immuno histochemically by two endothelial markers- anti-CD31 and Ulex Europaeus le ctin I (UEA-I), and the macrophage- specific marker anti-CD68. Microvessel and macrophage counts were performed using a grid at X200 and X400 magnific ation, respectively, in areas of maximal density ('hot spots'). Five fields were scanned. Microvessel counts were correlated with macrophage density, and both were c orrelated with patient age, tumor stage, histological grade, and survival. Results. Microvessel counts were comparable for ulex lectin (mean 6.8+/-4.8 /field) and CD31 (8.7+/-5.3/field), and results by both markers correlated (p<0.001). Counts by both markers correlated with tumor stage. being higher in stages Ib-IT compared to stage III-IV tumors (p<0.05). No correlation w ith age, grade, or survival was found. Macrophage counts (mean 13.1+/-12.3 cells/field) did not correlate with any of the clinical parameters studied or with microvessel counts. Conclusions. Microvessel counts and macrophage density do not correlate wit h survival in cervical cancer. Neither do they appear to be inter-related. The association between elevated microvessel counts and localized disease m ay reflect peak angiogenic stimuli by neoplastic cells. We hypothesize that the beneficial role of macrophages in cellular immunity may be opposed by the elaboration of growth factors in the vicinity of neoplastic cells.