Abstract

ABSTRACT: BACKGROUND: Tumor angiogenesis is essential for tumor growth and metastases. Recently ,studies showed that microvessel density (MVD),a measure of tumor angiogenesis has found to have a prognostic significance for predicting metastases and survival in endometrial adenocarcinoma and identifying patients at high risk for recurrences . The aim of this study is to understand the correlation between the MVD and various clinicopathological factors in endometrial adenocarcinoma in order to evaluate the role of angiogenesis in the assessment of the biological behavior of endometrial adenocarcinoma and to prove that MVD can be used as a valuable prognostic factor and can detect high risk patients for post-operative recurrence who may need adjuvant therapy after surgery . PATIENTS AND METHODS: Forty-one (41) cases were included in this study ; one case is normal endometrium in the proliferative phase , 5 cases with sever endometrial hyperplasia and 35 cases with endometrial adenocarcinoma taken from the Pathology Department at the Medical City and Private Pathology Laboratory between the years 2000-2004 . Paraffin blocks cut in two sections ; one for Haematoxylin & Eosin stain and the other for CD34 immunostaining slides were studied well for tumor grade ,stage ,myometrial invasion and pelvic and paraaortic lymph nodes metastases . The mean MVD was studied by scanning the tumor sections at a low power X40 and X100 then identifying areas of highest neovascularization (hot spots) .Five hot spot areas were selected from each section ,and the MVD were counted at X200 magnification (x10 ocular ,x20 objective) by taking the mean of those microvessels. The correlation between mean MVD and various clinicopathological factors were studied including the age ,tumor grade ,stage ,myometrial invasion and pelvic and paraaortic lymph nodes metastases . RESULTS : CD34 is a reliable and sensitive endothelial cell marker used in the assessment of tumor angiogenesis The study showed that a significant statistical correlation was found between the mean MVD and patients age , tumor grade and myometrial invasion. While there were no statistical correlation significance between the mean MVD and tumor stage and pelvic & paraaortic lymph nodes . CONCLUSION : We conclude that MVD is important in the assessment of the biological behavior of endometrial adenocarcinoma , where it is an indicator for the emergence and growth of tumor and it is important to detect patients at high risk of recurrences and to decide the post-operative adjuvant therapy