Zinovkin Dmitry Aleksandrovich, Pranjol Md Zahidul Islam, Petrenyov Daniil Rudolfovich, Nadyrov Eldar Arkadievich, Savchenko Oleg Gennadievich
University Research Laboratory, Gomel State Medical University, Gomel, Belarus.
University of Exeter Medical School, Institute of Biomedical and Clinical Science, Exeter, Devon, United Kingdom.
J Pathol Transl Med. 2017 Sep;51(5):456-462. doi: 10.4132/jptm.2017.07.19. Epub 2017 Sep 14.
In this study, we hypothesized that microcystic, elongated, fragmented (MELF)-pattern, vascular endothelial growth factor (VEGF) expression by cancer cells and microvessel density of cancer stroma may be associated with progression of endometrioid adenocarcinoma.
The study used data from the Belarus Cancer Registry and archival histological material of 100 patients with retrospectively known good (survival) and poor (disease progression and death) outcomes. All cases were immunohistochemically stained for CD34 and VEGF. Two independent samples were compared for the characteristics of signs, and obtained results were analyzed by receiver operating characteristic analysis, Mann-Whitney U test, χ test (Yates correction), and Mantel-Cox test. Multivariate Cox hazard analysis and Spearman correlation test were used. A p-value of less than .05 was considered statistically significant.
The observed survival rate of patients with endometrioid adenocarcinoma was significantly lower (p = .002) in MELF-pattern positive patients when compared with MELF-pattern negative patients. The overall survival rate of patients whose tumors had more than 114 vessels/mm of tissue was significantly low (p < .001). Interestingly, a similar observation was found in patients with increased vessel area, evidenced by VEGF expression in the glandular tumor component.
Our study suggests, for the first time, that these criteria may be used as risk factors of endometrioid adenocarcinoma progression during 5 years after radical surgical treatment. However, a large independent cohort of samples should be considered in the future to validate our findings.
在本研究中，我们假设癌细胞的微囊状、细长形、碎片化（MELF）模式、血管内皮生长因子（VEGF）表达以及癌间质微血管密度可能与子宫内膜样腺癌的进展相关。
本研究使用了白俄罗斯癌症登记处的数据以及100例患者的存档组织学材料，这些患者的预后（生存）情况已知，分为良好组和不良组（疾病进展和死亡）。所有病例均进行了CD34和VEGF的免疫组织化学染色。对两个独立样本的特征进行比较，并通过受试者工作特征分析、曼-惠特尼U检验、χ²检验（耶茨校正）和曼特尔-考克斯检验对所得结果进行分析。使用多变量考克斯风险分析和斯皮尔曼相关性检验。p值小于0.05被认为具有统计学意义。
与MELF模式阴性患者相比，MELF模式阳性的子宫内膜样腺癌患者的观察生存率显著较低（p = 0.002）。肿瘤组织中血管数量超过114条/mm的患者的总生存率显著较低（p < 0.001）。有趣的是，在腺性肿瘤成分中VEGF表达所证明的血管面积增加的患者中也发现了类似的观察结果。
我们的研究首次表明，这些标准可作为根治性手术后5年内子宫内膜样腺癌进展的风险因素。然而，未来应考虑纳入大量独立样本队列以验证我们的研究结果。
