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The 5-year survival rate of 87.2% in 36 patients with low TS expression was significantly improved compared with 36.8% in 30 patients with a high TS expression. Thus, a high TS expression may affect cell proliferation and migration, invasion and tumor proliferation, and may be a prognostic factor in advanced cervical cancer. High TS levels also reduce PDGFRB radiosensitivity and serve as a useful index for radiation treatment planning. Kawanaka et al (58) identified the expression of HIF-2�� in tumor-infiltrating macrophages in 72.6% of patients with primary advanced cervical SCC, and found that a high HIF-2��-positive cell count increased the risk of local recurrence following radiotherapy and was associated with a poorer disease-free CT99021 survival. HIF-2�� and HIF-1�� are associated with angiogenesis in tumors and are closely correlated with the invasion and metastasis of cancer cells (59,60). 4. Biomarkers in peripheral blood The hemoglobin (Hb) level in peripheral blood is a useful clinical measurement that reflects the oxygen status in cancer tissue (61). In a retrospective study comprising 386 patients with advanced cervical cancer, Girinski et al (62) concluded that a threshold Hb level of 10 g/dl is a significant prognostic factor and that improving anemia through blood transfusion during radiation therapy contributes to an improved prognosis. Similarly, in a review of 630 patients with cervical cancer treated with radiotherapy, Thomas (63) found that the average weekly Hb nadir level, rather than the baseline Hb level, was a significant prognostic factor, with a cut-off level of 12 g/dl. Thus, Hb is a useful prognostic factor in advanced cervical cancer and increasing the Hb level prior to or during treatment can also improve the long-term prognosis. In patients with cancer without lymph node metastasis, Hernandez et al (64) showed that those patients with peripheral blood platelet (Plt) counts of ��400��106/ml had a poorer prognosis compared with patients with Plt counts of check details cancer and conventional tumor markers, including SCC, have little significance in early diagnosis. However, these markers are often useful for evaluating outcome, the extent of tumor spread and prediction of prognosis. SCC was developed by Kato and Torigoe (65) as a tumor-associated antigen in cervical cancer, and particularly in SCC, with positive rates of 2.44% in carcinoma in situ, 22.2% in FIGO stage I, 56.7% in stage II, 76.4% in stage III, and 76.4% in stage IV cervical SCC.