Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China.
Department of Obstetrics and Gynecology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, P.R. China.
Histol Histopathol. 2020 Sep;35(9):1029-1034. doi: 10.14670/HH-18-234. Epub 2020 Jun 17.
Lymph node metastasis (LNM) is an important determinant of prognosis in patients with cervical cancer. Members of the angiopoietin family have been demonstrated to regulate tumor-associated angiogenesis and lymphangiogenesis. This study aimed to investigate the expression levels of angiopoietin-1 (ANG1) and angiopoietin-2 (ANG2) in clinically early stage of cervical cancer along with their correlations with LNM.
In total, 124 human cervical cancer cases classified into stage IA-IIB in accordance with the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging criteria were included. ANG1 and ANG2 expression levels in the tumor sections were assessed by immunohistochemistry (IHC). Univariate and multivariate logistic regression models, including age at diagnosis, FIGO stage, tumor size, pathological type, histological grading, depth of stromal invasion, lymph-vascular space invasion (LVSI) and the expression status of ANG1 and ANG2, were used to evaluate the odds ratios (ORs) for LNM.
ANG1 and ANG2 were positively expressed in 75 (60.5%) and 89 (71.8%) cervical cancers respectively, with predominant staining in the cytoplasm. ANG1 expression was significantly decreased in tumors with LNM, while no correlation was observed between ANG2 expression and LNM. More importantly, the multivariate logistic regression analysis demonstrated that high ANG1 expression was an independent protective factor of LNM (OR 0.107, 95% confidential interval [CI] 0.0200.567), while LVSI was an independent risk factor of LNM (OR 34.313, 95% CI 5.914199.092).
ANG1 is associated with a significantly decreased risk of LNM in early stage cervical cancer. The predictive value and role of ANG1 in LNM needs to be further investigated in future studies.
淋巴结转移（LNM）是宫颈癌患者预后的重要决定因素。血管生成素家族成员已被证明可调节肿瘤相关的血管生成和淋巴管生成。本研究旨在探讨血管生成素-1（ANG1）和血管生成素-2（ANG2）在临床早期宫颈癌中的表达水平及其与 LNM 的相关性。
共纳入 124 例按照国际妇产科联盟（FIGO）2009 分期标准分期为 IA-IIB 期的宫颈癌患者。采用免疫组织化学（IHC）法检测肿瘤组织中 ANG1 和 ANG2 的表达水平。采用单因素和多因素 logistic 回归模型，包括诊断时的年龄、FIGO 分期、肿瘤大小、病理类型、组织学分级、间质浸润深度、淋巴血管空间侵犯（LVSI）以及 ANG1 和 ANG2 的表达状态，评估 LNM 的比值比（OR）。
ANG1 和 ANG2 在 75（60.5%）和 89（71.8%）例宫颈癌中呈阳性表达，主要在细胞质中染色。LNM 肿瘤中 ANG1 表达明显降低，而 ANG2 表达与 LNM 无相关性。更重要的是，多因素 logistic 回归分析表明，高 ANG1 表达是 LNM 的独立保护因素（OR 0.107，95%置信区间 [CI] 0.0200.567），而 LVSI 是 LNM 的独立危险因素（OR 34.313，95% CI 5.914199.092）。
ANG1 与早期宫颈癌 LNM 的风险显著降低相关。ANG1 在 LNM 中的预测价值和作用需要在未来的研究中进一步探讨。
