Angiogenesis in cervical intraepithelial neoplasia and the risk of recurrence

OBJECTIVE: We sought to investigate whether angiogenesis can predict the ri sk of recurrence of cervical intraepithelial neoplasia after treatment. STUDY DESIGN: Microvessel density was studied in 75 patients with grade 3 c ervical intraepithelial neoplasia and in 20 patients with microinvasive squ amous carcinoma (International Federation of Gynecology and Obstetrics stag e (IA1) of the uterine cervix by staining representative tissue sections wi th the specific endothelial marker anti-CD31. The microvessel density was d etermined with a digital image analyzer. The results were correlated with c linical and histopathologic data. RESULTS: The mean vessel density was 264 per field (range, 86-674 per field ) in grade 3 cervical intraepithelial neoplasia and 378 per field (range, 1 61-848 per field; P =.001) in microinvasive squamous carcinoma. Thirteen pa tients with grade 3 cervical intraepithelial neoplasia had recurrent cervic al intraepithelial neoplasia (microvessel density, recurrent vs nonrecurren t; not significant). Multiple regression analysis in the noninvasive group confirmed that the mean vessel density (P =.121) had no prognostic value. F urthermore, it showed that the age at diagnosis (P=.011), menopausal status (P=.052), and treatment modality (P=.022) proved to be independent prognos tic factors for recurrence. CONCLUSIONS: During the progression from noninvasive to microinvasive cervi cal carcinoma, the microvessel density increases significantly However, the vessel density does not predict recurrence of noninvasive lesions.