EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY, cilt.40, sa.1, ss.65-68, 2019 (SCI-Expanded)
Purpose: One of the most important prognostic factors for endometrial carcinoma (EC) is myometrial invasion. Microcystic, elongated, and fragmented (MELF) myometrial invasion (MI) pattern is also important in terms of diversity of the invasion. To the best the present authors' knowledge, there is limited data about the significance of MELF type MI pattern, and lymph node (LN) involvement and therefore, the authors aimed to evaluate the frequency and association of MELF invasion pattern with other known prognostic factors in patients with EC. Materials and Methods: The authors reviewed the records of 102 patients who underwent staging surgery and had a result of EC in postoperative pathology in the present university clinic. Tissue specimens were re-evaluated according MI pattern (MELF positive or negative) by the same pathologist and the relation between the MELF pattern invasion and other prognostic factors were evaluated. Results: Stage Ia, Ib, II, IIIa, IIIb, and IIIc were observed 48 (47%), 29 (28%), 7 (7%), 11(11%), 1 (1%), and 6 (6%) in patients with EC respectively. Of the patients, MELF MI pattern was observed in 28 (27%) patients. When stage, grade, and MI patterns were compared, higher stage and grade were more frequently detected in patients with MELF pattern of MI. (p < 0.001) Moreover, none of the patients with grade 1 EC presented a MELF pattern MI. Patients with positive MELF MI pattern presented more lymphovascular space invasion (LVSI) (p < 0.001), LN metastasis (p < 0.05), and deeper MI (p < 0.001). Conclusion: Patients with MELF pattern of MI have more common LVSI and LN involvement.