Zinovkin Dmitry Aleksandrovich, Achinovich Sergey Leonidovich, Zubritskiy Mikhail Grigoryevich, Whatmore Jacqueline Linda, Pranjol Md Zahidul Islam
Department of Pathology, Gomel State Medical University, Gomel, Belarus.
Department of Pathology, Gomel State Clinical Oncological Dispensary, Gomel, Belarus.
J Pathol Transl Med. 2019 Sep;53(5):280-288. doi: 10.4132/jptm.2019.05.13. Epub 2019 Jun 27.
In this study, we investigate the expression of markers of angiogenesis and microvessel density (MVD) in cases of microcystic, elongated and fragmented (MELF) pattern, with its prognostic role in the survival of endometrioid endometrial adenocarcinomas (EA) patients.
In this study, 100 cases of EA, 49 cases with MELF pattern and 51 without, were immunohistochemically stained for galectin-1, vascular endothelial growth factor (VEGF), and MVD. Morphometry and statistical (univariate and multivariate) analyses were performed to assess overall survival (OS) and disease-free survival.
The expression of VEGF (p<.001) and galectin-1 (p<.001), as well as MVD area (p<.001) and number of vessels/mm2 (p<.050), were significantly higher in the +MELF pattern group compared to the -MELF group. A low negative correlation between MELFpattern and the number of days of survival (p<.001, r=-0.47) was also found. A low positive correlation of MELF-pattern with galectin-1 expression (p<.001, r=0.39), area of vessels/mm2 (p<.001, r=0.36), outcome of EA (p<.001, r=0.42) and VEGF expression (p<.001, r=0.39) suggests potential pathological relevance of these factors in the prognosis of EA. A univariate survival analysis indicated a role for all parameters of survival. Multivariate Cox proportional hazard regression analysis revealed that only area of vessels/mm2 (hazard ratio [HR], 1.018; 95% confidence interval [CI], 1.002 to 1.033), galectin-1 (HR, 1.049; 95% CI, 1.025 to 1.074) and VEGF (HR, 1.049; 95% CI, 1.022 to 1.077) play key roles in OS.
This study reports an increase in MVD, VEGF and galectin-1 expression in EA with MELF pattern and suggests that MELF pattern, along with the angiogenic profile, may be a prognostic factor in EA.
在本研究中，我们调查了微囊型、细长型和破碎型（MELF）模式病例中血管生成标志物的表达及微血管密度（MVD），及其对子宫内膜样腺癌（EA）患者生存的预后作用。
本研究纳入100例EA患者，其中49例具有MELF模式，51例无该模式，对其进行半乳糖凝集素-1、血管内皮生长因子（VEGF）和MVD的免疫组织化学染色。进行形态学和统计学（单变量和多变量）分析以评估总生存期（OS）和无病生存期。
与-MELF组相比，+MELF模式组中VEGF（p<0.001）和半乳糖凝集素-1（p<0.001）的表达，以及MVD面积（p<0.001）和每平方毫米血管数量（p<0.050）均显著更高。还发现MELF模式与生存天数之间存在低负相关性（p<0.001，r=-0.47）。MELF模式与半乳糖凝集素-1表达（p<0.001，r=0.39）、每平方毫米血管面积（p<0.001，r=0.36）、EA结局（p<0.001，r=0.42）和VEGF表达（p<0.001，r=0.39）之间存在低正相关性，提示这些因素在EA预后中可能具有潜在的病理相关性。单变量生存分析表明所有生存参数均起作用。多变量Cox比例风险回归分析显示，只有每平方毫米血管面积（风险比[HR]，1.018；95%置信区间[CI]，1.002至1.033）、半乳糖凝集素-1（HR，1.049；95%CI，1.025至1.074）和VEGF（HR，1.049；95%CI，1.022至1.077）在OS中起关键作用。
本研究报告了具有MELF模式的EA中MVD、VEGF和半乳糖凝集素-1表达增加，并表明MELF模式连同血管生成特征可能是EA的一个预后因素。
