Angiogenesis and platelet-derived endothelial cell growth factor thymidinephosphorylase expression in cervical cancer

The object of this study was to clarify the association of platelet-derived endothelial cell growth factor (PD-ECGF)/thymidine phosphorylase (dThdPase ), separately assessed in cancer cells and in stroma cells, with clinicopat hological factors including tumor angiogenesis and prognosis in cervical ca ncer. The expression of PD-ECGF was evaluated by immunohistochemical staini ng in 92 patients with stage Ib-II cervical cancer. The microvessel count w as assessed by immunostaining for factor VIII-related antigen in the most n eovascularized area. Microvessel count was significantly higher in tumors w ith non-squamous cell carcinoma. PD-ECGF expression in cancer cells was sig nificantly higher in tumors with pelvic node metastasis and squamous cell c arcinoma. Immunopositivity for PD-ECGF in stroma cells was significantly hi gher in tumors with large size and deep stromal invasion. The microvessel c ounts in cases with positive PD-ECGF expression in stroma cells were signif icantly higher than those in cases with negative PD-ECGF expression in stro ma cells (p=0.048). Disease-free survival and overall survival were signifi cantly worse in patients with deep stromal invasion, parametrial involvemen t, vaginal involvement, lymph-vascular space involvement, pelvic lymph node metastasis and high microvessel count. A multivariate analysis using Cox's proportional hazard model showed that high microvessel count independently predicted disease-free and overall survival. The expression of PD-ECGF in stroma cells may play a crucial role in the promotion of angiogenesis and t umor angiogenesis can be used as a useful prognostic marker for cervical ca ncer.