Indian Journal of Pathology and Microbiology
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Year : 2010  |  Volume : 53  |  Issue : 3  |  Page : 465-469

Peritumoral lymphatic vessel density as a prognostic parameter in endometrial carcinoma: An immunohistochemical study

1 Department of Pathology, MRI Alex University, Toronto, ON,Canada
2 Sunnybrook Health Science Centre, University of Toronto, Toronto, ON, Canada

Correspondence Address:
Ashgan I Elsarha
47, st.314 from Mostafa Kamel, Smouha, Alex, Egypt

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.68278

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Context: Lymphatic invasion and nodal metastasis play a major role in the spread and prognosis of endometrial adenocarcinoma (EC). Aims: In this study, we investigate tumor lymph-angiogenesis, detected by D2-40, as a predictive marker for the risk of lymph node (LN) metastasis and its relation to other prognostic parameters in EC. Materials and Methods: Fifty-five cases of EC treated with total hysterectomy and pelvic LN dissection were reviewed. All cases were immunostained for D2-40. Positively stained microvessels (MV) were counted in densely lymphovascular foci (hotspots) at X 400 field (0.17 mm2). Statistical Analysis: Statistical analysis was performing using Chi square "X 2" test. Results: Lymphovascular invasion was detected in 20 / 55 patients by D2-40 and 14 / 55 by routine hematoxylin and eosin (H and E). Peritumoral lymphatic vessel (LV) count was significantly higher than intratumoral LV count (17 + 7 versus 5 + 4 / 0.17 mm 2 , P < 0.01). Peritumoral D2-40 lymphovascular counts correlated significantly with FIGO grade (P < 0.001), lymphovascular invasion (P = 0.001) and LN metastases (P = 0.005). However, it showed non-significant correlation with peritoneal wash positivity (P = 0.830) and stage of the disease (P = 0.341). Intratumoral lymphovascular invasion detected by D2-40 showed significant correlation with LN metastases (P < 0.01). Conclusions: Our study shows that assessing LVD with D2-40 in the endometrial carcinoma might be a valuable parameter for predicting patients having an increased risk of developing of metastatic disease. In addition, D2-40 increases the frequency of detection of lymphatic invasion relative to routine H and E stain.

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