Clinicopathologic Factor, Endostatin Serum Level, and Vascular Endothelial Growth Factor-C (VEGF-C) Serum Level as Predictors of Lymph Nodes Metastasis in Early Stage Cervical Cancer Patients

Objective: To analyze endostatin serum level and VEGF-C serum level as predictors of lymph nodes metastasis and lymph nodes metastasis in early stadium of cervical cancers.Method: This research was done in Oncology Division, Department of Obstetrics and Gynecology Faculty of Medicine University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta. The design of this research was nested case control and consecutive sampling. The subjects were all of the early stadium cervical cancer patientsin Oncology clinic, Dr. Cipto Mangunkusumo hospital that had qualified according to inclusion criteria and exclusion criteria. The bloods were taken, the serums were separated, VEGF-C serums were examined by ELISA method, and endostatin serums were examined by Immunoassay method. Patients went through radical hysterectomy surgeries, and then pathology anatomy examinations.Result: The samples were 47 patient, consisted of 33 patients (70.21%) without lymph nodes metastasis and 14 patients (29.79%) with lymph nodes metastasis. By using ROC cut off point method, the obtained cut off point of VEGF-C level was 10,066.9 pg/ml,with sensitivity 78.57%, and specificity 96.97%. It was obtained the increasingrisk of lymph nodes metastasis in patients with VEGF-C level > 10,066.9 pg/ml compare to patients with VEGF-C level ≤ 10,066.9 pg/ml, with OR 80, 95% CI (7.99; 800.71), and p < 0.001. Based on cut off point, 184.5ng/ml, with sensitivity 64.3%, and specificity 63.4%, the endostatin level was divided into two groups, which were the < 184.5ng/ml group and the ≥ 184.5ng/ml group. Patients in ≥ 184.5 ng/ml group had the risk of lymph nodes metastasis 3.15 times more compare to patients in <184.5 ng/ml group, but not statistically significant (p=0.075, 95% CI (0.856;11.595)).Conclusion: VEGF-C serum levels can be used as prognosis factor or predictor of lymph node metastasis in early stage cervical cancer patients. Endostatin serum levels as the predictor of lymph node metastasis still need further research by adding sample quantity.[Indones J Obstet Gynecol 2011; 35-4:225-9]Keywords: endostatin, VEGF-C, lymph node metastasis, cervical cancer