TUMOR VASCULARITY - A NOVEL PROGNOSTIC FACTOR IN ADVANCED CERVICAL-CARCINOMA

被引:77
作者
SCHLENGER, K
HOCKEL, M
MITZE, M
SCHAFFER, U
WEIKEL, W
KNAPSTEIN, PG
LAMBERT, A
机构
[1] UNIV MAINZ, MED CTR, DEPT OBSTET GYNECOL, FRAUENKLIN, D-55101 MAINZ, GERMANY
[2] UNIV MAINZ, MED CTR, DEPT PATHOL, D-55101 MAINZ, GERMANY
关键词
D O I
10.1006/gyno.1995.1268
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: In the search for the optimal treatment of advanced cervical cancer, the identification of valid prognostic factors obtainable without histopathologic investigation of the entire tumor and the locoregional lymph nodes is of paramount interest. Tumor microvessel density has recently been demonstrated to correlate strongly with disease aggressiveness in breast cancer and other malignancies. Methods: We established a computerized image analysis system to quantify tumor microvascularity by using the closest-individual method, which determines the distribution of distances from random points within the tumor to the closest microvessel (DTCMV). Tumor microvascularity was assessed in paraffin sections of two cylindrical 2 x 20-mm core biopsies obtained transvaginally from the 12 and 6 o'clock positions of each tumor and then immunohistochemically stained for Factor VIII-related antigen. The oncologic relevance of tumor vascularity is studied in an open prospective trial. Results: Tumor vascularity was quantified in 42 patients with cervical cancers >3 cm in largest diameter, FIGO stages Ib-IVa. This new parameter representing pathophysiological tumor-host interactions was independent of various other patient and tumor characteristics, including age, FIGO stage, tumor size, differentiation, lymph node metastases and lymphatic space involvement. Thirty-nine patients were treated with curative intent either by primary surgery (n = 22) or radiation (n = 17), After a median observation time of 18 months (range 4-41 months), the patients with higher tumor vascularity (mean DTCMV <83 mu m) had significantly shorter disease-free (P = 0.025) and overall (P = 0.032) survival probabilities than patients with lower tumor vascularity (mean DTCMV greater than or equal to 83 mu m). Cox regression analysis identified tumor vascularity as the strongest independent prognostic factor in this group of patients. Conclusions: The assessment of tumor microvascularity by computerized image analysis of defined tumor biopsies could become a novel means of predicting tumor aggressiveness in non-early cervical cancer. (C) 1995 Academic Press, Inc.
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收藏
页码:57 / 66
页数:10
相关论文
共 30 条
  • [1] INTERCAPILLARY DISTANCE MEASUREMENT AS AN INDICATOR OF HYPOXIA IN CARCINOMA OF THE CERVIX UTERI
    AWWAD, HK
    ELNAGGAR, M
    MOCKTAR, N
    BARSOUM, M
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1986, 12 (08): : 1329 - 1333
  • [2] MICROVESSEL QUANTITATION AND PROGNOSIS IN INVASIVE BREAST-CARCINOMA
    BOSARI, S
    LEE, AKC
    DELELLIS, RA
    WILEY, BD
    HEATLEY, GJ
    SILVERMAN, ML
    [J]. HUMAN PATHOLOGY, 1992, 23 (07) : 755 - 761
  • [3] THE USE OF DISTANCE MEASURES IN PHYTOSOCIOLOGICAL SAMPLING
    COTTAM, G
    CURTIS, JT
    [J]. ECOLOGY, 1956, 37 (03) : 451 - 460
  • [4] SOME SAMPLING CHARACTERISTICS OF POPULATION OF RANDOMLY DISPERSED INDIVIDUALS
    COTTAM, G
    CURTIS, JT
    HALE, BW
    [J]. ECOLOGY, 1953, 34 (04) : 741 - 757
  • [5] DAVIDSON SE, 1994, INT J ONCOL, V5, P639
  • [6] FOLKMAN J, 1971, NEW ENGL J MED, V285, P1182
  • [7] WHAT IS THE EVIDENCE THAT TUMORS ARE ANGIOGENESIS DEPENDENT
    FOLKMAN, J
    [J]. JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1990, 82 (01): : 4 - 6
  • [8] TUMOR MICROVESSEL DENSITY, P53 EXPRESSION, TUMOR SIZE, AND PERITUMORAL LYMPHATIC VESSEL INVASION ARE RELEVANT PROGNOSTIC MARKERS IN NODE-NEGATIVE BREAST-CARCINOMA
    GASPARINI, G
    WEIDNER, N
    BEVILACQUA, P
    MALUTA, S
    DALLAPALMA, P
    CAFFO, O
    BARBARESCHI, M
    BORACCHI, P
    MARUBINI, E
    POZZA, F
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (03) : 454 - 466
  • [9] TUMOR OXYGENATION - A NEW PREDICTIVE PARAMETER IN LOCALLY ADVANCED CANCER OF THE UTERINE CERVIX
    HOCKEL, M
    VORNDRAN, B
    SCHLENGER, K
    BAUSSMANN, E
    KNAPSTEIN, PG
    [J]. GYNECOLOGIC ONCOLOGY, 1993, 51 (02) : 141 - 149
  • [10] INTRATUMORAL PO2 PREDICTS SURVIVAL IN ADVANCED CANCER OF THE UTERINE CERVIX
    HOCKEL, M
    KNOOP, C
    SCHLENGER, K
    VORNDRAN, B
    BAUSSMANN, E
    MITZE, M
    KNAPSTEIN, PG
    VAUPEL, P
    [J]. RADIOTHERAPY AND ONCOLOGY, 1993, 26 (01) : 45 - 50