Clinical, morphological and molecular markers in the formation of prognosis in patients with cervical cancer

Literature review

Authors

DOI:

https://doi.org/10.18370/2309-4117.2025.81.43-58

Keywords:

cervical cancer, cancer prognosis factors, cancer markers

Abstract

Cervical cancer (CC) remains one of the leading causes of cancer mortality among women in the world, despite significant progress in prevention, screening and
treatment. Due to risk factors associated with the development of CC (smoking, early onset of sexual activity, sexually transmitted infections, number of sexual partners, oral contraceptive use, and immunosuppression), this disease is characterized by an early asymptomatic course. Despite the current methods of treatment of CC (surgical, radiological, chemotherapeutic, as well as the introduction of immunotherapy and targeted drugs in recent years), the prognosis for CC remains unfavorable. The choice of the correct treatment regimen depending on the prognostic and predictive factors of the course of CC is the most important stage. Classical clinicopathological prognostic factors do not sufficiently explain the variability of the course of the disease in patients with similar tumor characteristics, especially at intermediate risk.
This review analyzes both known factors of prognosis of CC (stage of the disease, depth of stromal invasion, lymphovascular invasion, lymph node involvement, spread to the parametrium), and new markers, the role of which is actively studied: perineural invasion, tumor-free distance. Current data on known and promising prognostic biomarkers are summarized: the presence of human papillomavirus, viral load, proteins p16, p53, Ki-67, markers of hypoxia and angiogenesis HIF-1α, VEGF, serum antigens SCC Ag, CYFRA 21-1, hematological indices of systemic inflammation (NLR, PLR, PIV) and components of the tumor microenvironment, such as tumor-infiltrating lymphocytes
(TILs), tumor-associated macrophages (TAMs), cancer-associated fibroblasts (CAF), programmed death ligand 1 (PD-L1). The role of the new biological markers microRNAs is associated with the development of many malignant neoplasms, in particular CC.
The integration of these markers into clinical practice significantly increases the accuracy of predicting the course of CC, allows for a better assessment of the risk of recurrence and potential response to therapy, and also contributes to the individualization of treatment tactics. The presented review emphasizes the need for further multicenter studies to standardize and implement new prognostic markers into clinical practice.

Author Biographies

I.E. Yezhova, Danylo Halytskyi Lviv National Medical University; Municipal Non-Profit Enterprise of the Lviv Regional Council “Lviv Oncological Regional Treatment and Diagnostic”, Lviv

postgraduate student, Department of Oncology and Radiology;
gynecologist, oncologist

N.A. Volodko, Danylo Halytskyi Lviv National Medical University, Lviv

MD, professor, head of the Department of Oncology and Radiology

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2025-12-30

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Yezhova, I., & Volodko, N. (2025). Clinical, morphological and molecular markers in the formation of prognosis in patients with cervical cancer: Literature review. REPRODUCTIVE ENDOCRINOLOGY, (81), 43–58. https://doi.org/10.18370/2309-4117.2025.81.43-58

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No. 81 (2025)

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Tumors and pretumoral pathology

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