Increased microvascular proliferation is negatively correlated to tumour blood flow and is associated with unfavourable outcome in endometrial carcinomas
Haldorsen, Ingfrid S.; Stefansson, Ingunn; Grüner, Renate; Husby, Jenny Hild Aase; Magnussen, Inger Johanne; Werner, Henrica Maria Johanna; Salvesen, Øyvind; Bjørge, Line; Trovik, Jone; Taxt, Torfinn; Akslen, Lars A.; Salvesen, Helga Birgitte
Journal article, Peer reviewed
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http://hdl.handle.net/11250/282433Utgivelsesdato
2013-10-31Metadata
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Sammendrag
Background: We aimed to study the angiogenic profile based on histomorphological markers in endometrial carcinomas in
relation to imaging parameters obtained from preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)
and diffusion-weighted imaging (DWI) and to explore the potential value of these markers to identify patients with poor outcome.
Methods: In fifty-four surgically staged endometrial carcinoma patients, immunohistochemical staining with factor VIII and Ki67
allowed assessment of microvessel density (MVD) and microvascular proliferation reflecting tumour angiogenesis. In the same
patients, preoperative pelvic DCE-MRI and DWI allowed the calculation of parameters describing tumour microvasculature and
microstructure in vivo.
Results: Microvascular proliferation was negatively correlated to tumour blood flow (Fb) (r ¼ 0.36, P ¼ 0.008), capillary
permeability surface area product (PS) (r ¼ 0.39, P ¼ 0.004) and transfer from the blood to extravascular extracellular space (EES)
(Ktrans) (r ¼ 0.40, P ¼ 0.003), and was positively correlated to tumour volume (r ¼ 0.34; P ¼ 0.004). High-tumour microvascular
proliferation, low Fb and low Ktrans were all significantly associated with reduced progression/recurrence-free survival (Po 0.05).
Conclusion: Disorganised angiogenesis with coexisting microvascular proliferation and low tumour blood flow is a poor
prognostic factor supporting that hypoxia is associated with progression and metastatic spread in endometrial carcinomas.