Abstract :
Objectives: To evaluate the role of angiogenesis by the assessment of mean vessel density and to quantify
angiogenesis as an important variable in different benign and premalignant endometrial lesions.
Materials and Methods: Endometrial biopsies and hysterectomy specimens were examined to evaluate
and define any correlation between angiogenesis and different phases and premalignant diseased states of
the endometrium. 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 stain
and immunostain CD 34.
Results: A total of 381cases of benign and premalignant endometrial lesions were included in the study.
In 135 cases of simple hyperplasias, Microvessel Density (MVD) ranged from 2.4 - 6.7 and Mean MVD
was 4.71 on H&E stain and MVD ranged from 2.8 - 8.3 with Mean MVD of 5.39 on reticulin stain. In 105
cases of complex hyperplasias, MVD ranged from 2.3 - 7.0 and Mean MVD was 4.93 on H &E satin and
MVD ranged from 3.1-7.7 with Mean MVD of 5.68 on reticulin stain. In 67 cases of atypical hyperplasias,
inbudding and outpouching of the glandular epithelium together with multilayering was appreciated with
MVD from 4.5 - 8.8 and Mean MVD of 6.31 on H &E stain and MVD of 5.5 - 9.4 with Mean MVD of 7.19
on reticulin stain. A statistically significant difference was noted in all categories except in between simple
and complex hyperplasia where the difference was not statistically significant. The role of angiogenesis
becomes more significant with increasing severity of lesion, both in terms of hyperplasia and atypia when
compared to normal endometrium. Although angiogenesis can be detected on immunostain more easily, it
can be illustrated well by H and E or Reticulin stain.
Conclusions: Role of angiogenesis becomes more significant with increasing severity of lesion, both in
terms of hyperplasia and atypia when compared to normal endometrium. Although angiogenesis can be
illustrated well by routine H and E and Reticulin stains, it can be detected on immunostains with greater
degree of ease and accuracy.
Keyword :
Angiogenesis, Endometrium, Histopathology, MVD, Premalignant.