Significance of perivascular lymphocytic infiltrates in endometrial carcinoma.

Abstract

The objective of this study was to clarify the significance of perivascular lymphocytic infiltrates (PLI) in endometrial carcinoma. The pathologic records of 127 patients with endometrioid type adenocarcinoma confined to the uterus were reviewed retrospectively. The patients were divided into 4 groups based on the presence or absence of vascular invasion (VI) and PLI: VI-PLI- (n = 87), VI-PLI+ (n = 7), VI+PLI+ (n = 22), and VI+PLI- (n = 11). Pathologic features including tumor grade, myometrial invasion, cervical involvement, vascular invasion-associated changes (VIAC; VI and/or PLI), tumor size, ovarian metastasis, and pelvic lymph node metastasis were assessed statistically. Selective pelvic lymphadenectomy was performed in 108 patients, and metastasis was identified in 6 cases (5.6%). Lymph node metastasis was the only independent variable related to recurrence (Cox regression analysis, P = 0.0008). Perivascular lymphocytic infiltrates correlated closely with VI (Fisher exact test, P < 0.0001). Vascular invasion-associated changes was the best predictor of lymph node metastasis (logistic regression analysis, P = 0.039), but among the three categories of VIAC, only the VI+PLI- group was significantly associated with lymph node metastasis (P = 0.0045). The odds ratios of VI+PLI- and VI+PLI+ cases for lymph node metastasis were 64.54 and 3.24, respectively. Although VIAC is the best predictor of lymph node metastasis, the presence of PLI is associated with a lower risk of lymph node metastasis among VIAC groups.