Correlation between pre-therapeutic TPS and VEGF concentrations, in the serum of patients with cancer of the uterine cervix, and early effects of therapy

Abstract

Aim

To assess the relationship between pre-therapeutic serum TPS and VEGF levels and the results of treatment as measured immediately after completion of therapy.

Materials/Methods

The study included 146 women treated for cancer of the uterine cervix. Of these, 37 women were in stage I, 43 in stage II, 59 in stage III and 7 in stage IV of disease progression according to the FIGO classification. The ages of the patients ranged from 31 to 80 years. The dominant cancer observed was squamous cell carcinoma which accounted for more than 97% of cases. Samples were taken before commencement of treatment. Patients were treated by a combination of methods including radiochemotherapy, radical radiotherapy and palliative radiotherapy. The effects of therapy were graded after completion of irradiation according to generally accepted criteria. For tested criteria, ROC curves were drawn, determining cut-off points of 58 U/l for TPS and 500 pg/l for VEGF. For statistical calculations the U Mann-Whitney test was used.

Results

The level of VEGF expression varied between groups of patients in certain stages of disease progression (stages 1 & 2 and stages 2 & 3). Statistically significant differences were found between group PR in stage 2 and a control group of healthy women. Entry levels of TPS rose with tumor advancement (in stages 2, 3 & 4) and were higher than in a group of healthy women. Detected differences were statistically significant.

Conclusions

Only pre-therapeutic TPS levels show definite differences between degrees of clinical advancement and also with early therapeutic effects. Comparatively higher levels of serum TPS were found in patients with the worst prognosis prior to treatment (group P) than in the control group. This difference is statistically significant. Pre-therapeutic VEGF levels showed statistically significant differences between early (I, II) and advanced (III) clinical stages of the tumor as well as some effects of therapy assessed immediately after completion of treatment (PR vs S).