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doi: https://doi.org/10.4132/jptm.2019.05.13    [Epub ahead of print]
High Expression of Galectin-1, VEGF and Increased Microvessel Density are Associated with MELF Pattern in Stage I-III Endometrioid Endometrial Adenocarcinoma
Dmitry Aleksandrovich Zinovkin1 , Sergey Leonidovich Achinovich2 , Mikhail Grigoryevich Zubritskiy3 , Jacqueline Linda Whatmore4 , Md Zahidul Islam Pranjo5
1Department of Pathology, Gomel State Medical University, Gomel, Belarus
2Department of Pathology, Gomel State Clinical Oncological Dispensary, Gomel, Belarus
3Department of Pathology, Grodno Regional Clinical Bureau of Pathology, Grodno, Belarus
4Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, Devon, UK
5William Harvey Research Institute, Barts & The London School of Medicine & Dentistry Queen Mary University of London, London, UK
Corresponding Author: Md Zahidul Islam Pranjo ,Tel: +44-(0)207-882-2272, Email: z.pranjol@qmul.ac.uk
Received: February 1, 2019;  Revised: April 20, 2019  Accepted: May 13, 2019.  Published online: June 27, 2019.
ABSTRACT

Background:
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 cancer (EA) patients.
Methods:
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.
Results:
The expression of VEGF (p<.001) and galectin-1 (p<.001), as well asMVD area (p=.0003) and number of vessels/mm2 (p=.0043), were significantly higher in the +MELF pattern group compared to the –MELF group. A low negative correlation between MELF-pattern 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.
Conclusions:
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.
Key Words: Endometrioid endometrial carcinoma; MELF pattern; Galectin-1; Microvessel density; VEGF
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