title: Circulating vascular endothelial growth factors and their soluble receptors in pre-invasive, invasive and recurrent cervical cancer.
abstract: OBJECTIVE
  To study the impact of circulating vascular endothelial growth factors (VEGF) -A, -C and -D and their soluble receptors VEGFR-1/-2 on disease invasion and progression in patients with pre-invasive (CIN), invasive (PCC) and recurrent (RCC) cervical cancer.
  
  
  METHODS
  Blood samples were obtained from 125 women, including 50 cases of CIN, 51 of PCC and 24 of RCC, before treatment. Soluble (s) biomarker levels were determined by ELISA and tested for correlation with histopathological factors.
  
  
  RESULTS
  With disease progression, sVEGF-A (p = 0.007) and sVEGFR-2 (p = 0.014) significantly increased, while sVEGF-D (p = 0.046) decreased. sVEGFR-2 levels were increased in node+ patients (p = 0.024) and in metastatic disease (p = 0.003). sVEGF-A values were higher in HPV+ cases (p = 0.019). In detecting disease invasiveness, sensitivity and specificity were 76% and 48% for sVEGF-A, 52% and 32% for sVEGF-D, 25% and 94% for sVEGF-C, 93% and 6% for sVEGFR-1 and 73% and 34% for sVEGFR-2, respectively.
  
  
  CONCLUSIONS
  In cervical neoplasia, a switch from a lymphangiogenic phenotype towards a hemangiogenic phenotype occurs with disease invasion and progression. The sensitivity and specificity values, however, seem not convincing enough to establish these factors as clinical markers for disease invasiveness in cervical cancer.
authors.affiliation: Department of Gynecology and Obstetrics, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany. Sherko.Kuemmel@uk-essen.de
authors.forename: Sherko
authors.initials: S
authors.lastname: Kuemmel
authors.forename: Anke
authors.initials: A
authors.lastname: Thomas
authors.forename: Solveig
authors.initials: S
authors.lastname: Landt
authors.forename: Andrea
authors.initials: A
authors.lastname: Fuger
authors.forename: Peter
authors.initials: P
authors.lastname: Schmid
authors.forename: Monika
authors.initials: M
authors.lastname: Kriner
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Blohmer
authors.forename: Jalid
authors.initials: J
authors.lastname: Sehouli
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schaller
authors.forename: Werner
authors.initials: W
authors.lastname: Lichtenegger
authors.forename: Angela
authors.initials: A
authors.lastname: Köninger
authors.forename: Ilka
authors.initials: I
authors.lastname: Fuchs