A Comparing Study of the Expression Patterns of Vascular Endothelial Growth Factor (VEGF), Proliferating Cell Nuclear Antigen (PCNA), Apoptosis in CIN and Cervical Cancer.

Objective : The aim of this study was to identify the relationship between the progression of CIN (cervical intraepithelial neoplasia) to cervical cancer and expression pattern of VEGF, PCNA and apoptosis. Methods : We prepared forty paraffinized cervical tissue blocks consisting of each 10 CIN I, CIN II, CIN III, and invasive cervical cancer tissues, which had been already diagnosed histologically in Seoul National University Hospital from July, 1998 to June, 1999. The protein expression of VEGF and PCNA were examined by immunohistochemical staining. We defined PI (positive index) as the percentage of cells that were positive PCNA staining when examined in high power fields with light microscope (400). We used TUNEL staining to calculate apoptotic index defined as the number of the cells undergoing apoptosis per 1,000 tumor cells. To detect HPV type 16 or 18 from paraffin-embedded tissues, we selected the nested PCR method. Results : The VEGF expression showed significant difference between early cervical lesions (CIN I & II) and advanced cervical lesions (CIN III & cancer) (p=0.041). In case of PCNA expression there was no significant difference. When we define positive case as the case of which AI was greater than 5, AI according to each diagnosis showed no difference. In the aspect of HPV infection we could find that there was significant increment of HPV 16/ 18 infection rate in advanced cervical lesions (CIN III, cervical cancer) comparing with early cervical lesions such as CIN I, CIN II. Conclusion : Our results suggest that the evaluation of VEGF expression and HPV infection is potentially useful for the prediction of the progression of CIN to carcinoma.