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Biomarkers in carcinoma of the cervix: emphasis on tissue-related factors and their potential prognostic factors.

Despite the introduction of the PAP smear screening technique, cervical carcinoma continues to be a significant disease worldwide in terms of prevalence, morbidity and mortality. This paper reviews the prognostic value of biomarkers from some oncogenes, including c-myc, ras and c-erb B-2, the cellular proliferation markers PCNA and Ki-67, and other more recently described biomarkers such as nm23-H1, MN protein and metalloproteinase. Emphasis is given at a practical level to markers which can preferentially be applied to tissue sections rather than involving other modalities of investigation which may require specialised equipment and technology. No single marker of those previously listed was found to have outstanding prognostic significance. Although some have shown promise in initial studies subsequent investigations have not provided corroborating evidence, or, in some situations, have also led to conflicting results. Difficulties inherent in establishing the prognostic value of individual markers also include the multifactorial complexity of cervical carcinogenesis itself. The future awaits a greater amount of data to be accrued across all stages of disease, with improved standisation of results.