Expression of Vegf in Endometrial Hyperplasia with and Without Atypia And Endometrioid Endometrial Carcinoma and Its Association With Clinicopathological Parameters.
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Abstract
INTRODUCTION:
Endometrial carcinoma accounts for the second most common malignancy in women globally. The main risk factor being unopposed estrogen can cause the progression of endometrial hyperplasia to endometrial carcinoma. One of the important mechanisms behind the progression of cancer is angiogenesis.
Vascular Endothelial Growth Factor (VEGF) is one of major proangiogenic growth factor which is directed to assess the biological behavior of endometrial cancer and thereby using as an excellent targeted antiangiogenic therapy.
AIM:
To study the expression of VEGF in normal endometrium, endometrial hyperplasia (EH) and Endometrioid Endometrial Carcinoma (EEC) by immunohistochemistry and to evaluate its association with clinicopathological parameters.
MATERIALS AND METHODS:
The study was conducted in the Department of Pathology in a tertiary medical college, Kanchipuram, Chennai, India from November 2022- November 2023(13 months) constituting 30 patients who underwent hysterectomy. Histopathological diagnosis was obtained along with the grade and stage of cancer and immunohistochemical evaluation was done on the representative sections using VEGF antibody. Statistical analysis was done using SPSS software version 27.0
RESULTS:
Out of 30 cases, 3 cases were diagnosed as normal proliferative endometrium, 6 cases as EH without atypia, 5 cases as EH with atypia and 16 cases as EEC. Among 16 EEC cases, grade 1, 2 and 3 comprised 5,6 and 5 cases respectively. Strong VEGF positivity was observed in EEC (30%) compared to mild positivity in atypical EH (13.33%) and EH without atypia (10%) and 6% of normal proliferative endometrium showed negative expression thereby showing significant statistical association(p-value<0.002). Also, VEGF expression was significantly increased in grade 3 (31.25%) and grade 2(25%) cases in comparison to mild positivity in grade 1 cases (31.25%) demonstrating significant statistical association between VEGF scoring and grading of EEC.
CONCLUSION:
VEGF expression was significantly increased in high grade of EEC and can be used to differentiate endometrial carcinoma from its precursor lesions.