Prognostic significance of intratumour microvessel density and haemoglobin level in carcinoma of the uterine cervix

Abstract

The prognostic significance of intratumour microvessel density (IMD) and haemoglobin (Hb) level was studied in 152 (FIGO stage IB-IIIB) cervical cancer patients before radiotherapy. Patients' age and tumour stage, grade and degree of keratinization were also studied. IMD measurement expressed as the mean vessel count per I 1 mm2 was performed on formalin-fixed, paraffin-embedded tumour biopsies stained with anti-factor VIII antibody (DAKO Ltd.) using immunohistochemistry and the vascular hot-spot technique. The median age of patients was 55 years (29-80). Median values for IMD and Hb level were: 142.5 (range 56.3-476.6) vessels/mm2 and 129 (range 81-160) g/l, respectively. The median time of follow-up was 26 months, with a range of 2-145 months. Tumour stage (p = 0.7009), grade (p = 0.6660) and degree of keratinization (0.2669) were not significant in the Kaplan-Meier univariate analysis. However, patients' age > 50 years (p = 0.0079), high vascularity (IMD > 190.0 vessels/mm2, minimal cut-off point, p = 0.0503) and Hb concentration > 116 g/l (p = 0.0213) were favourable prognostic factors for cervical cancer treated with radiotherapy. In the Cox multivariate analysis only higher vascularity (IMD > 190/mm2 and Hb concentration > 116 g/l were favourable prognostic factors in terms of patients' survival. However, when a Cox analysis was done separately for keratinizing and non-keratinizing tumours, it was found that higher vascularity was significant only for keratinizing, and higher Hb level only for non-keratinizing cancers.