Expression of Angiopoietin and VEGF in Cervical Cancer and its Clinical Significance

Immunohistochemical Expression of Survivin and Vascular Endothelial Growth Factor in Cervical Squamous Cell Carcinoma

Uterine cervical cancer is the fourth leading cause of cancer death in women worldwide as per GLOBOCON (2020). In view of the higher incidence in the developing world and poor prognosis in cases presenting at advanced stage, there is an unmet need to explore new therapeutic targets for this neoplasm. Herein we sought to analyze and compare the immunoexpression of survivin (antiapoptotic factor) and vascular endothelial growth factor (VEGF). The study was conducted in the Department of Pathology at a tertiary care teaching institute from November 2018 to April 2020. Immunohistochemical (IHC) expression of survivin and VEGF was evaluated in 75 cervical squamous cell carcinomas (CSCC). The immunostaining was evaluated semi-quantitatively for its intensity (mild = 1; moderate = 2; intense = 3) and proportion of positivity (< 5% = 0; 5 to 25% = 1; 26 to 50% = 2; > 50% = 3). IHC score was calculated by multiplying the two scores as low positive (1-3), medium positive (4-6) and strong positive (7-9). Immunoexpression of survivin and VEGF was correlated using the Fisher's exact test and Kendall rank correlation coefficient. The median age of the CSCC patients was 55 years. Survivin expression was found in 98.6% while VEGF expression was observed in 68% of cases. A significant positive correlation (p - 0.001, τ - 0.404) was found between immunoexpression of survivin and VEGF. Our study results highlight the proposed role of survivin in angiogenesis by promoting VEGF expression. Hence, in view of survivin being an antiapoptotic protein and having a role in angiogenesis, targeted therapy against survivin might be of use for treatment and better prognostic outcomes in cervical squamous cell carcinomas.

Potential VEGFR2 inhibitors for managing metastatic cervical cancer: insights from molecular dynamics and free energy landscape studies

Metastatic cervical cancer, the advanced stage where the cancer spreads beyond the cervix to other parts of the body, poses significant treatment challenges and is associated with poor survival rates. Vascular Endothelial Growth Factor Receptor 2 (VEGFR2), a critical angiogenic mediator, is upregulated in metastatic cervical cancer, driving the formation of new blood vessels that fuel tumor growth and spread, making it an attractive target for anti-angiogenic therapies aimed at halting metastasis. This study aims to determine the anti-angiogenic effects of natural compounds to identify new VEGFR2 inhibitors for managing metastatic cervical cancer. The potential effect of these compounds as VEGFR2 inhibitors at the structural level was assessed using various methods such as virtual screening, docking, MD simulations (1000 ns), binding free energy calculations, and free energy landscape analysis. Four compounds, including IMPHY007574, IMPHY004129, IMPHY008783, and IMPHY004928, were found to be potential VEGFR2 inhibitors. Among the structures analyzed in the present work, IMPHY007574 revealed the highest binding stability with VEGFR2 and the most favorable interaction pattern, thus proving the possibility of its use as an effective anti-angiogenic compound. The other three compounds also demonstrated a reasonably good promise in VEGFR2 inhibition. These findings provide a foundation for developing novel therapeutic strategies for metastatic cervical cancer, potentially overcoming drug resistance and improving patient survival rates.

Research progress on the structure, function, and use of angiogenin in malignant tumours

Angiogenin (ANG) is a specialised secreted ribonuclease, also known as RNase5, that is widely expressed in vertebrates. ANG dysregulation is closely associated with the development of breast, nasopharyngeal, and lung cancers. In recent years, studies have found that ANG not only induces neovascularisation by activating endothelial cells, but also plays a regulatory role in the plasticity of cancer cells. Cellular plasticity plays pivotal roles in cancer initiation, progression, migration, therapeutic resistance, and relapse. Therefore, it is a promising biomarker for cancer diagnosis, prognostic evaluation, and therapy. This review summarises the current knowledge regarding the roles and clinical applications of ANG in cancer development and progression.

Emerging biomarkers and molecular targets for precision medicine in cervical cancer

Cervical cancer remains a significant global health burden, necessitating innovative approaches for improved diagnostics and personalized treatment strategies. Precision medicine has emerged as a promising paradigm, leveraging biomarkers and molecular targets to tailor therapy to individual patients. This review explores the landscape of emerging biomarkers and molecular targets in cervical cancer, highlighting their potential implications for precision medicine. By integrating these biomarkers into comprehensive diagnostic algorithms, clinicians can identify high-risk patients at an earlier stage, enabling timely intervention and improved patient outcomes. Furthermore, the identification of specific molecular targets has paved the way for the development of targeted therapies aimed at disrupting key pathways implicated in cervical carcinogenesis. In conclusion, the evolving landscape of biomarkers and molecular targets presents exciting opportunities for advancing precision medicine in cervical cancer. By harnessing these insights, clinicians can optimize treatment selection, enhance patient outcomes, and ultimately transform the management of this devastating disease.

Associations of human papillomavirus genotypes and cervical vascular abnormality in a cohort of women underwent colposcopy, a retrospective study of 6716 patients

Aims

Abnormal vessel patterns are specific signs in patients with early cervical abnormality and cervical cancer(CC) by colposcopy, but the impact of human papillomavirus (HPV) infections on abnormal vessel patterns remains unknown.

Methods

A total of 6716 female patients with HPV infections or cytological abnormalities who underwent a colposcopy following abnormal CC screening results were included in the study. The final pathological diagnosis was confirmed to be the most severe pathological grade across cervical biopsy, endocervical canal curettage (ECC) and conization. Univariate and multivariate logistic regression analyses were used to investigate the association between HPV infections and abnormal vessel patterns, adjusting for age, gravidity and parity.

Results

There were 6124 normal vascular cases by colposcopy and 592 cases with cervical vascular abnormality. The prevalence of HPV infections was 4284 (70%) in normal patients, and the prevalence of HPV infections was 479 (80%) in cervical vascular abnormality patients. HPV high-risk type 16 infection alone increased the risk of cervical heteromorphic blood vessels (aOR=3.66, 95%CI: 2.54~5.27). HPV 16 and 33 alone (other than the commonly recognized subtype of 18) or coinfection of these two genotypes could increase the risk of cervical punctate vascular and cervical vascular mosaic features and abnormal cervical blood vessels. An increased risk of abnormal cervical lesions was observed for HPV 16 and 33 alone or combined in coinfection compared to the negative group. The risk of cervical vascular abnormality was increased 10-fold by coinfection with HPV 16 and 33 (aOR=10.67, 95% CI: 4.54~25.09, P&lt;0.001). HPV 16, 33 alone or combined in coinfection were associated with an increased risk of lesions more advanced than high-grade squamous intraepithelial lesion (HSIL) when compared to the negative group. The risk of lesions more advanced than HSIL was up to 26-fold higher in the coinfection with HPV 16 and 33 group than in the negative group (aOR=26.23, 95%CI: 11.23~61.27, P&lt;0.001).

Conclusion

HPV16 and 33 are the most dangerous HPV genotypes correlated with abnormal vascular patterns. Combined HPV16 and HPV33 infection increases the risk of abnormal vascular patterns. Combined HPV16 and HPV33 infection increases the risk of developing HSIL+.

Histological analysis of TGFβ1 and VEGFR expression in cervical carcinoma treated with Rhodomyrtus tomentosa

Cervical carcinoma is one of the most common malignant carcinomas around the world, including Indonesia. Rhodomyrtus tomentosa is an herbal medicine that is often used in Asia as a therapeutic agent to stop cancer metastases. The process of neoangiogenesis in cervical cancer depends on VEGFR activity. Increased TGFβ1 production is also linked to cervical cancer, suggesting that gene inactivation contributes to the emergence of cervical carcinoma.

Group C- was the control group, Group C+ was the cancer model group, CER100 was the group of rats with cancer + 100 mg/kg body weight (BW) of R. tomentosa, CER200 was the group of rats with cancer + 200 mg/kg BW of R. tomentosa, and CER400 was the group of rats with cancer + 400 mg/kg BWR. tomentosa. Rats were dissected after administration of R. tomentosa for 30 days. Immunohistochemical staining of the cervical tissue was performed with TGFβ1 and VEGFR antibodies. VEGFR expression was significantly different from TGFβ1 expression (p &lt; 0.01). The highest expression was observed at the lowest dose of R. tomentosa (100 mg/kg BW), and the lowest expression was observed at 200 and 400 mg/kg BW. The administration of R. tomentosa can repair tissue damage and decrease the expression of TGFβ1 and VEGFR via histopathological parameters, indicating the importance of the activity of these proteins in the development of neoangiogenesis in cervical cancer.

Combined treatment of marizomib and cisplatin modulates cervical cancer growth and invasion and enhances antitumor potential in vitro and in vivo

Proteasome inhibition is an attractive approach for anticancer therapy. Cisplatin (cis-diamminedichloroplatinum, CDDP) is widely used as a standard chemotherapy drug in the treatment of solid malignant tumors, such as cervical cancer, ovarian cancer, colorectal cancer, and lung cancer. However, the development of CDDP resistance largely limits its clinical application. Proteasome inhibitors may enhance traditional chemotherapy agent-induced cytotoxicity and apoptosis. Marizomib (NPI-0052, salinosporamide A, Mzb), a second-generation proteasome inhibitor, shows synergistic anticancer activity with some drugs. Currently, the effect of Mzb on cervical cancer cell proliferation remains unclear. In this study, we explored the role of Mzb in three cervical cancer cell lines, HeLa, CaSki, and C33A, representing major molecular subtypes of cervical cancer and xenografts. We found that Mzb alone showed noteworthy cytotoxic effects, and its combination with CDDP resulted in more obvious cytotoxicity and apoptosis in cervical cancer cell lines and xenografts. In order to investigate the mechanism of this effect, we probed whether Mzb alone or in combination with CDDP had a better antitumor response by enhancing CDDP-induced angiopoietin 1 (Ang-1) expression and inhibiting the expression of TEK receptor tyrosine kinase (Tie-2) in the Ang-1/Tie-2 pathway, FMS-like tyrosine kinase 3 ligand (Flt-3L) and stem cell factor (SCF) as identified by a cytokine antibody chip test. The results suggest that Mzb has better antitumor effects on cervical cancer cells and can sensitize cervical cancer cells to CDDP treatment both in vitro and in vivo. Accordingly, we conclude that the combination of CDDP with Mzb produces synergistic anticancer activity and that Mzb may be a potential effective drug in combination therapy for cervical cancer patients.

Longitudinal Dynamics of Coagulation and Angiogenesis Markers in Cancer Patients During and After Chemotherapy

Hemostatic parameters have been investigated as molecular determinants of tumor progression. To analyze the dynamics of microparticle-associated tissue factor activity (MPTF), tissue factor antigen (TF-Ag), and angiopоietin-2 (ANG-2) in cancer patients before, during, and after active treatment and to explore their potential as biomarkers for metastatic occurrence and death. Blood for the analysis of MPTF, TF-Ag, ANG-2, and conventional hemostatic tests was sampled in 111 patients with various cancers at 4 consecutive visits: before first chemotherapy cycle, after 3 courses, at the sixth course, and 3 months after chemotherapy cessation. Patients were followed up until metastatic progression/death or the end of the study. MPTF did not change during chemotherapy, but increased significantly after treatment cessation. Total TF-Ag and ANG-2 decreased throughout active treatment. Significant drop of their levels was observed 3 months post therapy cessation. Progressive disease was significantly associated with higher pre-chemotherapy TF-Ag and fibrinogen. Elevated baseline levels of fibrinogen were associated with increased risk of shortened progression free survival. Cessation of chemotherapy is associated with significant change of hemostatic parameters. Pre-chemotherapy levels of TF-Ag and fibrinogen may be informative of disease state and prognosis.