Correlation between Vegf-C Expression in Tissue and Serum Vegf-C in Patients with Bulky Cervical Cancer Receiving Paclitaxel – Carboplatin Neoadjuvan Chemotherapy


Heru Priyanto1), Ambar Mudigdo2), Andrijono3), Bhisma Murti4)

1)Department of Obstetrics and Gynecology, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret

2)Department of Anatomic Pathology, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret

3)Departmentof Obstetrics and Gynecology, Dr. Cipto Mangunkusumo Hospital/ Faculty of Medicine, Universitas Indonesia

4)Masters Program in Public Health, Universitas Sebelas Maret

 

ABSTRACT

Background: The development of cervical cancer is highly dependent on the ability of cancer cells to form new capillaries and lymphatic vessels. Neo-adjuvant chemotherapy shrinks tumor size and reduces angiogenesis. Of the various growth factors that regulate angiogenesis, VEGF-C is the first-rank lymphangiogenic factor. VEGF-C can be measured by several methods. This study aimed to determine: (1) the effect of neo-adjuvant chemotherapy in reducing tissue VEGF-C expression and serum VEGF-C level; (2) the correlation between VEGF-C expression in tissueand serum VEGF-C in patients with bulky cervical cancer receiving paclitaxel – carboplatin neoadjuvan chemotherapy.

Subjects and Method: This was a quasi experiment conducted at the Obstetrics and Gynecology Department and the Pathology and Anatomy Department, Dr. Moewardi Hospital, Surakarta, Central Java, from May to September 2017. A sample of 30 patients with cervical cancer stage IB2 and IIA2 was selected for this study. The independent variable was paclitaxel – carboplatin neoadjuvan chemotherapy. The dependent variables were VEGF-C expression in tissue and VEGF-C serum. Tissue VEGF-C expression and serum VEGF-C level were measured before and after neo-adjuvant chemotherapy. The data were analyzed by Wilcoxon test and Spearman correlation.

Results: TissueVEGF-C expression before chemotherapy (mean= 6.17) was higher than after therapy (mean= 4.17), and it was statistically significant (p< 0.001). Serum VEGF-C level before chemotherapy (mean= 9574.60) was higher than after therapy (mean= 7827.63), and it was statistically significant (p= 0.006). Tissue VEGF-C expression was correlated with serum VEGF-C, but it was statistically non-significant (r= 0.15, p= 0.218).

Conclusion: Neo-adjuvant chemotherapy reduces both VEGF-C tissue expression and serum VEGF-C levels. There is a weak and insignificant correlation between tissue VEGF-C expression and serum VEGF-C levels in patients with cervical cancer given neo-adjuvant chemotherapy.

Keywords: VEGF-C, neo-adjuvant chemotherapy, cervical cancer

CorrespondenceHeru Priyanto. Department of Obstetrics and Gynecology, Dr. Moewardi Hospital/Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir.Sutami No. 36 A, 57126, Surakarta, Central Java. Mobile: 081331529944.

DOI: https://doi.org/10.26911/mid.icph.2018.05.08

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