Influence of Serum VEGF Levels on Therapeutic Outcome and Diagnosis/Prognostic Value in Patients with Cervical Cancer

  • Du, Ke (Department of Oncology, Xiangyang Central Hospital) ;
  • Gong, Hong-Ying (Department of Neurology, Xiangyang Central Hospital) ;
  • Gong, Zhi-Min (Department of Oncology, Xiangyang Central Hospital)
  • Published : 2014.11.06


Objective: To explore the influence of serum vascular endothelial growth factor (VEGF) level on therapeutic outcome and diagnosis/prognostic value in patients with cervical cancer. Materials and Methods: A total of 37 patients diagnosed with cervical cancer by biopsy were selected and treated with concurrent chemoradiotherapy. Double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was adopted before treatment to assess VEGF levels, and its relationships with clinicopathological features and short-term therapeutic effects were analyzed. Results: The median VEGF level in 37 patients before treatment was 647.15 (393.35~1125.16) pg/mL. Serum VEGF levels in patients aged <50 years, in International Federation of Gynecology and Obstetrics (FIGO) stage IIIa~IVa, with lymph node metastasis and tumor size >4 cm were significantly increased (P<0.05). The complete remission (CR) rate was 48.7% (18/37), partial remission (PR) rate was 35.1% (13/37), stable disease (SD) rate was 13.5% (5/37) and progressive disease (PD) rate was 2.70% (1/37), so the objective remission rate (ORR) after treatment was 83.8% (31/37). Logistic regression analysis showed that tumor size and serum VEGF level before treatment were independent risk factors affecting the therapeutic outcome, and the higher the level of serum VEGF, the worse the prognosis when tumor size>4 cm. Some 56.8% of patients manifested with myelosuppression, 37.8% with leucopenia, 24.3% with thrombocytopenia, 5.41% with diarrhea, 46.0% with nausea and vomiting, 21.6% with hair loss and 8.11% with hepatic and renal injury during the treatment. Conclusions: Serum VEGF level may reflect the degree of malignancy of cervical cancer and predict therapeutic effect, which is of great importance to cancer diagnosis and prognosis.


  1. Belfort-Mattos PN, Focchi GR, Speck NM, et al (2010). Immunohistochemical expression of granzyme B and vascular endothelial growth factor (VEGF) in normal uterine cervices and low and high grade squamous intraepithelial lesions. Eur J Gynaecol Oncol, 31, 459-61.
  2. Barbu I, Craitoiu S, Simionescu CE, et al (2013). CD105 microvessels density, VEGF, EGFR-1 and c-erbB-2 and their prognostic correlation in different subtypes of cervical adenocarcinoma. Rom J Morphol Embryol, 54, 519-30.
  3. Gong J, Zhu S, Zhang Y, et al (2014). Interplay of VEGFa and MMP2 regulates invasion of glioblastoma. Tumour Biol, 12, [Epub ahead of print].
  4. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90.
  5. Katanyoo K, Chantarasri A, Chongtanakon M, et al (2011). Pretreatment levels of serum vascular endothelial growth factor do not correlate with outcome in patients with locally advanced cervical cancer. Asian Pac J Cancer Prev, 12, 699-702.
  6. Kim NS, Kang YJ, Jo JO, et al (2011). Elevated expression of thymosin $\beta{4}$, vascular endothelial growth factor (VEGF), and hypoxia inducible factor (HIF)-$1\alpha$ in early-stage cervical cancers. Pathol Oncol Res, 17, 493-502.
  7. Liu Y, Ye Z, Sun H, et al (2013). Grading of uterine cervical cancer by using the ADC difference value and its correlation with microvascular density and vascular endothelial growth factor. Eur Radiol, 23, 757-65.
  8. Nagy VM, Buiga R, Brie I, et al (2011). Expression of VEGF, VEGFR, EGFR, COX-2 and MVD in cervical carcinoma, in relation with the response to radio-chemotherapy. Rom J Morphol Embryol, 52, 53-9.
  9. Peirson L, Fitzpatrick-Lewis D, Ciliska D, et al (2013). Screening for cervical cancer: a systematic review and meta-analysis. Syst Rev, 2, 35.
  10. Srivastava S, Gupta A, Agarwal GG, et al (2009). Correlation of serum vascular endothelial growth factor with clinicopathological parameters in cervical cancer. Biosci Trends, 3, 144-50.
  11. Stepan D, Simionescu C, Stepan A, et al (2012). VEGF and CD105 immunoexpression in squamous cervical carcinomas and associated precancerous lesions. Rom J Morphol Embryol, 53, 585-9.
  12. Salomon-Perzynska M, Perzynski A, Rembielak-Stawecka B, et al (2014). VEGF--targeted therapy for the treatment of cervical cancer --literature review. Ginekol Pol, 85, 461-5.
  13. Zusterzeel PL, Span PN, Dijksterhuis MG, et al (2009). Serum vascular endothelial growth factor: a prognostic factor in cervical cancer. J Cancer Res Clin Oncol, 135, 283-90.

Cited by

  1. Inhibitory Effects of Dunning Rat Prostate Tumor Fluid on Proliferation of the Metastatic MAT-LyLu Cell Line vol.16, pp.2, 2015,
  2. synergistic anti-tumor effect of paclitaxel nanoparticles combined with radiotherapy on human cervical carcinoma vol.24, pp.1, 2017,