ImpactU Versión 3.11.2 Última actualización: Interfaz de Usuario: 16/10/2025 Base de Datos: 29/08/2025 Hecho en Colombia
Prognostic role of microvascular density (DMV), VEGF, EGFR, and HIF-1 α expression and their relationship with epitelial mesenquimal transition (EMT) in patients with locally advanced cervical cancer (LACC) treated with chemoradiotherapy.
e22028 Background: In low and middle income countries cervical carcinoma is the second leading cause of death among women. Methods: To describe the prognostic value of MVD and protein expression of several genes related to survival and proliferation and their relationship with EMT of LACC. Overall response rates (ORR), clinical benefit (CB), progression-free survival (PFS), and overall survival (OS) were estimated for women suffering from LACC treated with chemoradiotherapy followed by high dose rate brachytherapy (HDRB). Results: Sixty-one patients were included (mean age 52±10); all of them had LACC (2.3% 2A/47.5% 2B/4.9% 3A/37.7% 3B/3.3% 4A/3.3% not defined), a tumour mean size of 6.4cm (SD±1.8cm) and HPV infection in 46% of the cases. Fifty-eight patients (95%) had a squamous pattern, two were adenocarcinomas and >50% presented moderated or poorly differentiated neoplasms. All of them were treated with chemotherapy (transitory interruption of external radiotherapy was documented in 19% due to toxicity and in 21.4% of cases by other causes/mean cycles of platinum administered during radiotherapy 4.8 ± 1.0) and brachytherapy (77% completed all planed intracavitary treatment). The median PFS and OS was 6.6 months (4.0-9.1) and 30 months (11-48) respectively. None of the variables had effect on PFS, whilst multivariate analysis revealed that VEGF (p=0.026) and EGFR expression levels (p=0.030) and <6 cm tumour volume (p=0.02) positively influenced the OS. TWIST expression and E-cadherine lost expression (E-) also influence OS (p=0.001) and (p=0.02) respectably and are related with VEGF and EGFR expression. When EGFR or VEGF are coexpressed with TWIST or related with E- expression the patients shows the worst OS (median 14 m CI 95% 3-24 m, p=0.02 for EGFR (+) and E- ; VEGF (+) and E - median 14 m CI 95% 3-25 m p=0.0001; EGFR (+) and TWIST (+) 19 m CI 95% 15-80 m, p=0.006; VEGF (+) and TWIST (+) 18 m CI 95% 15-80 m, p=0.0001. Conclusions: Classifying LACC patients treated with cisplatin-based chemoradiotherapy by protein expression and EMT markers had a positive influence on prognosis.