Influence of initial platinum-based chemotherapy on levels of He-4 protein and VEGF-A in primary tumors and metastases from ovarian cancer

Introduction. Recently, the he-4 protein has received great attention due to its diagnostic and prognostic abilities in epithelial ovarian cancer. In addition to its diagnostic value, this protein is involved in the pathogenesis of ovarian cancer. Another significant pathogenetic factor is the vascular endothelial growth factor (vegf) which plays a key role in neoangiogenesis. The purpose of the study focused on the analysis of he-4 and vegf-a levels in tissues of ovarian cancer, in healthy contralateral ovaries and in common metastatic tumors in the omentum and peritoneum to determine the place and role of these tumor markers at the stages of carcinogenesis. Material and methods. The study was performed using the abovementioned tissues of 93 patients with t2-3nхm0-1 ovarian cancer. 51 patients underwent surgery followed by chemotherapy. 42 patients received initial neoadjuvant chemotherapy followed by surgery and adjuvant cytostatic therapy. Tissue samples from 17 patients with benign diseases were used as the control for determining the reference values for he-4 and vegf-a. A comparison was made between groups of patients with and without neoadjuvant therapy, as well as in groups of patients depending on the effectiveness of cytostatic treatment. Results. The levels of he-4 in primary and metastatic tissues affected and not affected by cancer were initially elevated in patients with ovarian cancer. The chemotherapy effectiveness directly correlated with the level of he-4 reduction, which did not change or increased in tumors resistant to medical treatment. The level of vegf-a significantly differed in cancer and non-cancer tissues, which indicated its significant pathogenetic effect not “before”, but at the stages of morphological malignization. The dynamics of vegf-a decrease in this study did not depend on the chemotherapy effect. Conclusion. The he-4 marker is a pathognomonic factor in the development of ovarian cancer, preceding morphological signs of malignancy and reflecting the effectiveness of chemotherapy, while vegf-a is most likely a consequence of the cancer development.

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