High Microvascular Density (MVD) as a Risk Factor for Poor Response to Neoadjuvant Paclitaxel-Carboplatin Chemotherapy in Stage IB۳, IIA۲, and IIB Cervical Cancer

Background & Objective: Cervical cancer remains a major health burden, especially in developing countries. Neoadjuvant Chemotherapy (NACT) is commonly used for locally advanced disease, but treatment responses vary, highlighting the need for predictive biomarkers. Microvascular Density (MVD), a marker of tumor angiogenesis, has been proposed as a predictor of chemotherapy response. This study was conducted with aim to evaluate the role of MVD in cervical cancer prognosis and treatment response. Materials & Methods: This nested case-control study was conducted on ۵۲ patients with stage IB۳–IIB cervical cancer treated with three cycles of paclitaxel-carboplatin NACT. Patients were categorized as poor responders (n=۲۶) or good responders (n=۲۶) according to RECIST criteria. MVD was assessed by immunohistochemistry on paraffin-embedded biopsy specimens. ROC analysis was used to determine the optimal MVD cut-off, and its association with treatment response was assessed using Odds Ratios (OR) and ۹۵% Confidence Intervals (CI). Data were analyzed using SPSS (version ۲۴.۰). P<۰.۰۵ was considered significant. Results: Mean MVD was higher in poor responders (۴۹.۱۵±۲۲.۶۳) than good responders (۲۴.۸۰±۱۳.۶۰), though not statistically significant (P=۰.۱۲). ROC analysis identified a cut-off of ۲۸.۵ (sensitivity ۸۰.۸%, specificity ۷۳.۱%, AUC ۰.۶۱۸). High MVD (≥۲۸.۵) was significantly associated with poor response to NACT (OR=۱۱.۴۰; ۹۵% CI: ۳.۰۹-۴۲.۰۲; P<۰.۰۰۱). Conclusion: High MVD expression is a significant predictor of poor response to neoadjuvant paclitaxel-carboplatin chemotherapy in cervical cancer. MVD may serve as a clinically useful biomarker to guide treatment selection.

کلیدواژه ها:

cervical cancer ، Microvascular density (MVD) ، Neoadjuvant chemotherapy ، Chemotherapy response