Reduced expression of tissue factor pathway inhibitor-2 contributes to apoptosis and angiogenesis in cervical cancer

This study involved 12 normal cervical squamous epithelia, 48 cervical intraepithelial neoplasia (CIN), and 68 cervical cancer. The expression of TFPI-2, Ki-67 and vascular endothelial growth factor (VEGF) were investigated by immunohistochemistry staining. The apoptolic index(AI) was determined with an in situ end-labeling assay(TUNEL). And the marker of CD34 staining was used as an indicator of microvessel density (MVD).TFPI-2 expression has a decreasing trend with the progression of cervical cancer and was significantly correlated with FIGO stage, lymph node metastasis and HPV infection. In addition, there were significant positive correlations between the grading of TFPI-2 expression and AI(P = 0.004). In contrast, the expression of TFPI-2 and VEGF or MVD was negatively correlated (both p < 0.001). However, we did not establish any signi？cant correlation between Ki-67 and TFPI-2 expression in cervical cancer.The results suggested that the expression of TFPI-2 had a decreasing trend with tumor progression of cervical cancer. There was a close association between the expression of TFPI-2 and tumor cell apoptosis and angiogenesis in patients with cervical cancer. TFPI-2 may play an inhibitive role during the development of cervical cancer.Cervical cancer is the second most common malignancy in women around the world [1]. Cervical cancer occurs in a multi-step process, a sequential transition from a cervix with a normal epithelium to cervical intraepithelial neoplasia (CIN) and invasive cervical cancer. It is clear that persistent high-risk Human Papillomavirus (hr-HPV) infections are the strongest epidemiologic risk factor for the development of invasive cervical cancer [2]. However, HPV infection alone is not suf？cient to cause cervical cancer. Consequently, much interest has been focused on the molecular basis which contribute to drive the progression of cervical cancer. Proteolytic degradation of the extracellular matrix (ECM) is considered to be an essential st