Study of serum vascular endothelial growth factor [VEGF] level among cases of endometrial carcinoma in postmenopausal females

ABSTRACT

The aim of this work is to correlate the preoperative serum level of vascular endothelial growth factor [VEGF] to proved cases of endometrial carcinoma among the postmenopausal females. The study included forty postmenopausal females that were divided into two subgroups Group A [cases] Twenty patients having endometrial carcinoma diagnosed by biopsy from endometrial tissues obtained by dilatation and curettage, admitted to the inpatient department of El Shatby Maternity University Hospital. Group B [control] Twenty postmenopausal volunteered females with no gynecologic pathology having endometrial thickness less than 4 mm proved by transvaginal ultrasound. The selected females were subjected to thorough personal, family, obstetric, gynecological,history and Physical examination. Transvaginal ultrasound scanning was done to all cases to measure endometrial thickness and the uterine vessels were visualized and Pulsatility index [PI] and Resistance index [RI] were calculated Estimation of serum vascular endothelial growth factor [VEGF] by enzyme immune assay [EIA] for the Detection of [i]Total human VEGF[i] was done to all patients. Total abdominal hysterectomy and bilateral salpingoophorectomy was done to group A only [patients having endometrial carcinoma] and histopathological examination of the removed tissues was done. The results of the ultrasound measurements of endometrial thickness, color Doppler velocimetry, platelet count and serum VEGF values were compared between both groups. group A [study group] and group B [control group] were compared according to normal statistical tests as regards Age and parity,Weight and height, Age of menarche, Years since menopause, Contraceptive methods used, Platelet count, Endometrial thickness by transvaginal ultrasound, Transvaginal color Doppler velocimetry including PI, RI and endometrial texture, and Serum VEGF level. Group A [cases] had a mean age of 56.85 +/- 5.174 years and a mean parity of 2.35 +/- 0.813 children; that were not statistically different from group B [control] which had a mean age of 55.15 +/- 2.39 years and a mean parity of 2.95 +/- 1.276 children. Group A [cases] had a significantly lower mean age of menarche of 11.52 +/- 0.89 years than group B [control] which had a mean age of menarche of 12.33 +/- 0.90 years. There was no statistical significant difference between both groups as regard to years since menopause. Group A had mean years since menopause of 5.82 +/- 1.03 years while group B had mean years since menopause of 6.01 +/- 1.11 years. Group A [cases] had a significantly higher mean endometrial thickness of 21.625 +/- 2.923 mm in comparison to group B [control] which had a mean thickness of 3.03 +/- 0.66 mm. Group A [cases] showed significant higher mean serum VEGF level of 258.21 +/- 90.286 ng/ml than group B [control] which had a mean serum VEGF level of 24.415 +/- 7.167 ng/ml. Endometrial thickness measurement by transvaginal ultrasonography is efficient in suspecting endometrial carcinoma in postmenopausal females. Transvaginal color Doppler velocimetry on both uterine arteries did not add on efficacy in the diagnosis of endometrial carcinoma. Serum VEGF was found to be of precious value for the prediction of endometrial carcinoma