Alterações do estroma e parâmetros inflamatórios hematológicos no câncer de colo uterino avançado

Abstract

OBJECTIVES: The objectives of the study were to compare the cervical stroma in patients with advanced cervical cancer with the control group; to compare, in the pre-treatment period, blood count parameters (platelets, neutrophil-lymphocyte ratio - NLR, platelet-lymphocyte ratio - PLR, RDW) in patients with advanced cervical cancer (stage ≥ IIB) with the same parameters as control group; and in cervical cancer, to verify if there is an association of immunostaining of stromal markers with pathological and systemic prognostic factors. METHODS: We prospectively evaluated 16 patients diagnosed with advanced invasive cervical cancer (stage ≥ IIB), confirmed by biopsy. A control group of 22 patients was used (patients undergoing hysterectomy for uterine leiomyoma). Immunohistochemistry was performed to verify the stromal immunostaining of SMA (alpha-smooth muscle actin) and FAP (fibroblast activation protein alpha) in cervical biopsy of patients and the control group. Immunostainings were compared between groups using Fisher's exact test. The results of the hemogram parameters were compared using the Mann-Whitney Test. Differences were considered significant for p<0.05. RESULTS: Strong FAP immunostaining (2/3) was more frequent in patients with cervical cancer when compared with patients with myoma (p=0.0005). Regarding SMA, strong immunostaining (2/3) was also found more in the group of cancer patients compared to the group of patients with myoma (p < 0.00001). The NLR values were higher in the cancer patient group compared to the control group (p=0.0019). Regarding the PLR values, these were also higher in the cancer group than in the leiomyoma group, but at the threshold of significance (p=0.0675). There was no significant difference in the evaluation of the two stromal markers in cervical cancer in the study of pathological prognostic factors (staging and histological grade) nor in the study of systemic factors. CONCLUSION: Strong FAP and SMA immunostaining (2/3) were found more in the group of patients with cervical cancer when compared to the control group. The NLR values were also higher in the group of cancer patients.