Remodeling of angiogenesis and lymphangiogenesis in cervical cancer development

Abstract

The ability to stimulate angiogenesis/lymphangiogenesis is an intrinsic property of cancer cells, providing them necessary conditions for growth and metastasis. The “angiogenic switch” is one of the earliest consequences of malignant transformation; it involves altered expression of numerous genes and triggers a complex set of signaling pathways in endothelial cells. Processes of tumor microvascular network formation are closely associated with the stages of carcinogenesis (from appearance of benign lesions to invasive forms) and occur with numerous deviations from the norm. Analysis of expression of proangiogenic factors during sequential steps of cervical cancer development (intraepithelial neoplasia, cancer in situ, microinvasive, and invasive cancer) provides opportunity to reconstruct the regulatory mechanisms of angiogenesis/lymphangiogenesis with emphasis on the most important components. This review summarizes literature data on expression of key regulators of angiogenesis in cervical intraepithelial neoplasia and cervical cancer and analyses their possible involvement in molecular mechanisms of neoplastic transformation of epithelial cells, as well as invasion and tumor metastasis. Correlation between expression of proangiogenic molecular factors and various clinicopathological parameters is considered in the context of their possible use in molecular diagnostics and targeted therapy of cervical cancer. Special attention is paid to rather poorly studied regulators of lymphangiogenesis and “non-VEGF dependent,” or alternative, angiogenic pathways that constitute the prospect of future research in the field.