Effect Of Interventional Treatment On VEGF,MVD Of Cervical Carcinoma

Objective: To study the effect of vascular endothelial growth factor (VEGF) and mictovascular density(MVD) in occurrence and development of cervical squmous carcinoma and the difference of expression of VEGF and MVD between before intra-arterial chemotherapy and after that, evaluate the feasibility and efficacy possibility of intra-arterial chemotherapy followed by radical hysterectomy of cervical squamous carcinoma.Methods: Immunohistochemistry Envision method was performed to detect the expression of expression of VEGF and MVD of 30 cases cervical carcinoma before and after interventional treatment, and analyzed in a conjunction with the expression of VEGF and MVD before intra-arterial chemotherapy.Results: VEGF positive expression lower level in cervical squamous carcinoma before intra-arterial chemotherapy was 70% (21/30)and higher level was 30%(9/30). VEGF positive expression rate in the patients after intra-arterial chemotherapy lower lever was53.3% (16/30) and high lever was 46.7%(14/30) (P<0.05). VEGF positive expression level in cervical squamous carcinoma before intra-arterial chemotherapy was significantly higher than that after radical hysterectomy .VEGF positive expression rate in cervical squamous carcinoma with stag II was significantly higher than that with stage I (P<0.05). VEGF positive expression rate in the patients with lymph node metastasis was significantly higher than the patients without lymph node metastasis. MVD expression was not correlated to metastasis, the clinical stage of the tumor and the grade of histology. But MVD (29.6±7.5) in the patients with lymph node metastasis was significantly higher than the patients without lymph node metastasis MVD (21.5±6.7) (P<0.05)。Before and after interventional treatment, MVD decreased remarkably from 26.3±6.5 to 5.6±5.3(P<0.001). VEGF expression was correlated to MVD. All patients in cervical squamous carcinoma were underwent radical hysterectomy. Complete response (CR) was achieved in 18 of 30 patients (60%);while a partial response (PR) was noted in 10(33%);no change in 2 (6%), and no patient had progressive disease. CR and PR were effective, the total response rate was 93%.The radical hysterectomy rate was 100%,4 patients had pelvic lymph node metastasis. There were no severe complications related to intra-arterial chemotherapy and radical hysterectomy.Conclusions: The higher expression of VEGF in cervical squamous carcinoma may play an important role in the angiogenesis of cervical squamous. VEGF and MVD may be a sign of cervical squamous carcinoma. Intar-arterial chemotherapy before operation can shrink tumor size, decrease the lymph node mestastasis. Interventional treatment can decrease expression of VEGF and MVD and suppress the growth and metastasis on cervical cancer. So intra-arterial chemotherapy before operation is a feasible and efficacious assistant method .