Vascular endothelial growth factor and prognosis of cervical carcinoma

Objective: To evaluate vascular endothelial growth factor (VEGF) as a marke r for predicting lymph node metastasis and an independent prognostic factor of early-stage cervical carcinoma. Methods: One hundred thirty-five women with stage IB-IIA cervical carcinoma had radical abdominal hysterectomies and pelvic lymph node dissections. In tratumoral cytosol VEGF concentrations were assayed with enzyme immunoassay . Histopathologic items and cytosol VEGF-influencing clinical outcomes were compared. Results: Twenty-two women (16.3%) who had disease recurrence had higher lev els of cytosol VEGF (1020 versus 112 pg/mg protein, P < .001) than those wi thout recurrence. Using a cutoff value of 400 pg/mg protein resulted in bes t sensitivity of 75%, best specificity of 70%, positive predictive value of 41%, and negative predictive value of 92%. Only overexpressed cytosol VEGF (hazard ratio 6.44, P < .001) was an independent prognostic factor of dise ase-free survival. The overexpressed cytosol VEGF (hazard ratio 4.50, P = . 021) and positive lymphovascular emboli (hazard ratio 4.11, P = .045) were independent prognostic factor of overall survival. Conclusion: Cytosol VEGF might be a biomarker for the status of pelvic lymp h nodes in early-stage cervical carcinoma and an independent prognostic ind icator of its outcome. (Obstet Gynecol 2000;96:721-6. (C) 2000 by The Ameri can College of Obstetricians and Gynecologists).