An Immunohistochemical Study on Intratumoral and Peritumoral Lymphatic Vessel Density as a Prognostic Parameter in Endometrial Carcinoma

Preetha, S (2019) An Immunohistochemical Study on Intratumoral and Peritumoral Lymphatic Vessel Density as a Prognostic Parameter in Endometrial Carcinoma. Masters thesis, Madras Medical College, Chennai.


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BACKGROUND: Lymphatic invasion and nodal metastasis play major role in the spread and prognosis of endometrial adenocarcinoma. AIM OF THE STUDY: 1. To study tumor lymph-angiogenesis, detected by D2-40, as a predictive marker for the risk of lymph node metastasis and its relation to other prognostic parameters in Endometrial carcinoma. 2. To compare the efficacy of Pipelle sampling and Endometrial curettage in detecting endometrial carcinoma and to compare the concordance of FIGO grade of endometrial adenocarcinomas in pre-operative biopsy and hysterectomy specimens. MATERIALS & METHODS: This is atwoyear prospective and retrospective study conducted in the department of Pathology, Institute of Obstetrics and Gynaecology, Chennai on patients diagnosed as endometrial carcinoma in hysterectomy. All the patients were subjected to immunohistochemical analysis with D2-40 and lymphatic vessel scoring was done. The following parameters like histologic type, FIGO grade, depth of myometrial invasion, lymphovascular invasion, pelvic and paraaortic lymphnode status, omental deposits, peritoneal wash cytology and FIGO staging were correlated with lymphatic vessel scoring. RESULTS: Among them, 54 cases were subjected to immunohistochemical analysis with D2-40, remaining 3 cases were excluded due to lack of representative section of tumour. We also included 5 cases of nonneoplastic lesions and 3 cases of premalignant lesions of endometrium. • The mean age of endometrial carcinoma was 56 years, postmenopausal with bleeding per vaginum being the most common clinical presentation. • Incidence of endometrial carcinoma in women below 40 years was found to be 5.6%. • Most common histologic type was Endometrioid adenocarcinoma constituting 83.3% with 50% constituting Grade I, 16.7% of grade II and Grade III each. • Non endometrioid cases were 7.4% of malignant mixed Mullerian tumour, 5.6% of clear cell carcinoma of endometrium and 1.8% of papillary serous carcinoma and mucinous adenocarcinoma each. • Out of the 54 cases of endometrial carcinoma, 41 of them underwent endometrial sampling preoperatively of which 65.9% were of endometrioid adenocarcinoma. CONCLUSION: This study showed significant correlation of D2-40 positive lymph vessels with mean age, histologic type, depth of myometrial invasion, peritoneal wash status and stage of endometrial carcinoma. This study concludes that both pipelle and curettage are equally effective in detecting endometrial carcinoma preoperatively and the Concordance of FIGO grade between preoperative biopsy and hysterectomy specimens was statistically significant with both methods. Out of the 54 cases, follow up of 35 cases was available. All of them were under clinical follow up and the comment on prognosis can only be made on long term follow up.

Item Type: Thesis (Masters)
Uncontrolled Keywords: D2-40, podoplanin, lymphatic vessel, endometrial adenocarcinoma, FIGO grade.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 24 Aug 2019 10:54
Last Modified: 24 Aug 2019 10:59

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