Naki M Murat, Oran Gülbin, Tetikkurt Seza Ümit, Sönmez Cavide Fatma, Türkmen İlknur, Köse Faruk
Department of Obstetrics and Gynecology, Acıbadem University Faculty of Medicine, İstanbul, Turkey.
Department of Pathology, Medipol University Faculty of Medicine, İstanbul, Turkey.
J Turk Ger Gynecol Assoc. 2017 Sep 1;18(3):139-142. doi: 10.4274/jtgga.2017.0016.
To investigate the association of microcystic, elongated, and fragmented (MELF) pattern of invasion with prognostic factors in endometrioid endometrial adenocarcinoma (EEA).
Stained tissue sections from 83 cases of EEA operated by the same gynecologic oncologist were reviewed to identify cases showing MELF-type invasion in this retrospective study. The association of MELF pattern with age, tumor grade, depth of myometrial invasion, and presence of lymphovascular space invasion (LVSI) was analyzed.
FIGO grade 2 and grade 1 tumors were evident in 53.0% and 38.6% of patients, respectively. Depth of myometrial invasion was <50% in 72.0% of patients, and LVSI was absent in 77.1%. MELF pattern was confirmed in 35 (42.2%) patients. Presence of MELF pattern was associated with significantly higher mean ± standard deviation age (62.9±6.9) years vs. 58.9±9.1 years, p=0.033), and found to be more likely in patients with high-grade tumor (FIGO grade III; 85.7% vs. 14.3%, p<0.001), deep (≥50%) myometrial invasion (78.3% vs. 21.7%, p<0.001), and presence of LVSI (94.7% vs. 5.3%, p<0.001) as compared with absence of MELF pattern.
In conclusion, our findings revealed a high rate of MELF pattern among patients with EEA alongside the association of MELF pattern with poor prognostic factors such as high grade tumor, deep myometrial invasion, and LVSI.
探讨微囊性、细长形及破碎状（MELF）浸润模式与子宫内膜样腺癌（EEA）预后因素的相关性。
本回顾性研究中，对同一位妇科肿瘤学家手术的83例EEA病例的染色组织切片进行复查，以确定显示MELF型浸润的病例。分析MELF模式与年龄、肿瘤分级、肌层浸润深度及脉管间隙浸润（LVSI）的相关性。
FIGO 2级和1级肿瘤分别在53.0%和38.6%的患者中可见。72.0%的患者肌层浸润深度<50%，77.1%的患者无LVSI。35例（42.2%）患者证实存在MELF模式。存在MELF模式的患者平均年龄±标准差显著更高（62.9±6.9岁 vs. 58.9±9.1岁，p = 0.033），并且发现与无MELF模式的患者相比，高级别肿瘤（FIGO III级；85.7% vs. 14.3%，p<0.001）、深部（≥50%）肌层浸润（78.3% vs. 21.7%，p<0.001）及存在LVSI（94.7% vs. 5.3%，p<0.001）的患者更易出现MELF模式。
总之，我们的研究结果显示EEA患者中MELF模式发生率较高，且MELF模式与高级别肿瘤、深部肌层浸润及LVSI等不良预后因素相关。
