Assessment of Microvessel Density and Angiogenesis in Endometrial Carcinomas

Objective: To evaluate the role of angiogenesis in tumor growth by the assessment of microvessel
density and to quantify angiogenesis as an important variable in endometrial cancers.
Materials and Methods: 103 cases of endometrial malignancies (epithelial tumors-76 cases, stromal
tumors-07 cases and metastatic tumors-20 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 CD34.
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.
CD34 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.
Conclusions: 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.