The Relationship Between The Expression Of Heparanase, Basic Fibroblast Growth Factor, And Infiltration, Metastasis And Prognostic Of Cervical Carcinoma

Background and ObjectiveCervical cancer (CC) is one of the three malignant cancers that threatens women's health. According to statistics, the incidence of CC is gradually rising.the infiltration and matastasis process of cervical cancer are important factors for the evaluation of the prognosis of cervical cancer. Heparanase (Hpa) is a glucaronate incision enzyme, which could split HS expressed in ECM and BM. It plays an important role in the vascularization, infiltration and matastasis process of cancer. Some studies show that Hpa may plays a role in the vascularization, infiltration and matastasis process cervical cancer. Basic fibroblast growth factor (bFGF) can strongly promotes the process of caryomitosis of many kinds of cells, promotes cell proliferation and synthesis, and promotes DNA synthesis and vascularization. It directly or indirectly involves in many physiological and pathological processes, such as wound healing and the development of cancer. Both Hpa and bFGF play important role in the process of infiltration and matastasis of gynecological malignant cancer, and can be used as prognostic evaluation index. The present study was undertaken to approach the expression level of both Hpa and bFGF in cervical cancer tissues, and their relationship with the infiltration, matastasis and prognosis of cervical cancer.Materials and Methods Samples of fifty patients with cervical cancer who have undergone hysterectomy at No.2 Affiliated Hospitai were enrolled in this study (from 1993.1 to 2003.1). Fifty EC samples were identified with 29 moderate differentiated cases and 21 well differentiated cases according to histopathologic grades. FIGO Staging indicated that 30 cases were in stageⅠ,15 cases were in stageⅡ; and 5 cases were inⅢA. Immunohistochemical Staining method was used to detect the Hpa and bFGF immunoreactivity of 50 cases with CC and 25 control group cervix.Kaplan-Meier curve, F-test, t-test and Spearman rank correlation were used to analyze the data. The significant difference was considered when P value was less than 0.05,α=0.05 was considered significant.ResultsThe expression of HPa and bFGF in atypia hyperplastic endometrium and cervical carcinoma samples were significantly higher than those in normal endometrium samples (P=0.015, P=0.025, respectively).In the 50 cervical carcinoma samples, HPa was positive in 35 samples and bFGF in 37 samples. The survival rate of patients with positive expression of HPa or bFGF was significantly lower than that of patients with negative expression of HPa or bFGF (P=0.0013, P=0.0053, respectively).The expression level of HPa and bFGF in cervical carcinoma samples with vessel infiltration and lymphatic metastasis were significantly higher than those in the samples without vessel infiltration and lymphatic metastasis. The expression level of bFGF was higher in highly differentiated samples than in poorly differentiated ones, and the difference was significant (P=0.025).The expression level of HPa was positive correlated with the expression of bFGF (r=0.408, P=0.003).ConclusionThis study confirms that the expression of Hpa and bFGF were significantly high in cervical cancer tissues.The expression level of Hpa gradually increases in nomal cervix, CIN and cervical cancer, and the aberrant expression of Hpa was positively correlated with clinical stage.The expression level of bFGF gradually increases in nomal cervix, CIN and cervical cancer, and the expression of bFGF was positively correlated with clinical stage, vessel invasion and lymph nodes metastases. The interaction between Hpa and bFGF promotes the process of development,invasion and metastasis of cervical cancer.