ASSOCIATION OF SERUM HYPOXIA MARKERS (VASCULAR ENDOTHELIAL GROWTH FACTOR, CARBONIC ANHYDRASE IX, AND LACTATE) WITH HYPOXIA-INDUCIBLE FACTOR-1 ALPHA EXPRESSION IN CERVICAL CANCER TISSUES: POTENTIAL IMPLICATIONS FOR TREATMENT RESPONSE AND TARGETED THERAPY

Objectives: To determine whether circulating serum hypoxia markers (vascular endothelial growth factor [VEGF], carbonic anhydrase IX [CA-IX], and Lactate) are associated with tumor hypoxia-inducible factor-1 alpha (HIF-1α) expression in cervical cancer, and to assess the possible utility of these biomarkers for therapy-oriented risk stratification. Methods: In this observational study, patients with histopathologically confirmed cervical cancer were enrolled before starting any definitive treatment. Pre-treatment blood samples were analyzed for serum hypoxia markers (VEGF, CA-IX, and Lactate) using validated biochemical assays. HIF-1α expression in tumor tissue was evaluated by immunohistochemistry and graded semi-quantitatively. Relationships between serum marker levels and HIF-1α scores were examined using correlation testing, and comparisons were made across clinicopathological variables relevant to treatment planning. Results: Patients showing strong HIF-1α expression had significantly higher serum hypoxia marker levels (VEGF, CA-IX, and Lactate) than those with low/absent expression (mean±standard deviation: 8.6±2.1 vs. 5.2±1.7 units; p