Citation Information :
Nair IR, Rajanbabu A, Ambikakumari S, Kunneri B, Keechilat P. Evaluation of Morphological and Immunohistochemical Patterns Associated with MELF Type of Myoinvasion in Type I Endometrial Carcinomas. J South Asian Feder Obs Gynae 2022; 14 (5):505-509.
Introduction: Endometrial carcinomas constitute a variety of tumors with varied morphology and clinical outcome. Though type I carcinomas were found to have better prognosis, subsequent studies have shown that 5–10% of type-I carcinomas may recur or metastasize, thus shortening the overall survival. This has led to the search of additional factors which might predict adverse outcomes in these otherwise low-grade tumors. Several histological and immunohistochemical markers were studied and some of them were found to be significantly associated with lymph node metastasis, recurrence, and poor outcome.
Methods: In total, 50 cases of type-I, grade-1/2 endometrioid carcinomas were studied for microcystic, elongated, and fragmented (MELF) type of myoinvasion. About 23 cases showed MELF myoinvasion. The morphological and immunohistochemistry (IHC) pattern associated with MELF were studied. Their association with lymph node metastasis and survival was also noted. IHC done were cytokeratin (CK), CD44, progesterone receptor (PR), E-cadherin, and smooth muscle actin.
Results: Large tumor size, papillary pattern, and lymphovascular emboli (LVE) were associated with MELF. Among the IHC, expression of CD44 and loss of expression of PR and E-cadherin were found to be statistically significant. None of the cases showed lymph node metastasis on routine sections, however, ultrastaging was not done.
Conclusion: Morphological and IHC features differ between MELF-positive and -negative cases. There was no significant difference in survival between the MELF-positive and -negative cases.
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