Micro-vessel density as a guide to angiogenesis in human endometrium

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 an