Assessment of Mean Vessel Density and Angiogenesis in Endometrial Carcinomas.

Objective: To evaluate the role of angiogenesis in tumor growth by the assessment of mean vessel density and to quantify angiogenesis as an important variable in endometrial cancers. Material and Methods: 53 cases of endometrial malignancies (epithelial tumors-36 cases and metastatic tumors-17 cases), were analysed for histological types, grades and features like depth of invasion and vascular invasion. Microvessel counts were performed by examining the microvessels thoroughly in terms of count, morphology and density after staining the tissues by hematoxylin & eosin stain, reticulin and immunostain (Antifactor VIII Ag). Results: On H&E stain - Microvessel density (MVD) in endometrial malignancy ranged from 3.0 - 13.5 and mean MVD was 8.78. On Reticulin stain - MVD ranged from 3.5 - 15.2 and mean MVD was 9.76. Antifactor VIII sections showed very small microvessels or even single endothelial cells with the highest total counts and the MVD ranged from 6.5- 16.8 with Mean MVD of 11.7. The counts increased with the grade of the tumor in the absence of necrosis or haemorrhage. MVD counts also increased with the stage, being 8.12 in Stage I disease, 8.65 in Stage II and 10.8 in stage III disease. Atypical hyperplasia was found to be associated with epithelial tumors in 8 cases, making it a significant finding. Conclusion: Role of angiogenesis assumes greater significance with increasing severity of lesions, higher grade and stage of the tumor and seems to have an important diagnostic and prognostic significance.

Avaliação do fluxo sanguíneo tumoral e das artérias uterinas com Doppler triplex e sua corrlação com fatores prognósticos em câncer de endométrio / Evaluation of tumoral flow and uterine arteries with triplex Doppler sonography and its correlation with prognosis factors in endometrial cancer

Propusemos avaliar a importância da densidade vascular e impedância do fluxo sangüíneo nas artérias tumorais e uterinas, detectada por ultra-sonografia Doppler tríplex em relação à presença de fatores prognósticos em cancer de endométrio. Foram incluídas no estudo 61 mulheres (média etária de 65,9 anos) com diagnóstico histológico prévio da doença. Ultra-sonografia transvaginal com Doppler pulsado e de amplitude foi realizada sendo registrados os IR e a densidade vascular definida previamente com valor de 1 quando não se identificavam vasos, 2 quando escassos vasos eram detectados e 3 quando numerosos vasos estavam presentes (> 5) / We proposed to evaluate the importance of the vascular density and impedance by the sanguineous flow in the uterine and tumoral arteries, detected by triplex Doppler sonography, in relation to the presence of prognostic factors in endometrial cancer. There were included in the study 61 women (average age of 65.9 years) with previous histologic diagnosis of disease. Transvaginal ultrasonography with pulsed and amplitude Doppler were executed, being registered the RI and vascular density defined previously with the value of 1, when the vessels were not identified, 2 when rare vessels were detected and 3 when numerous sanguineous vessels were present (>5)...