Prognostic Significance of Endoglin (CD105) as an Angiogenic Marker in Endocervical Adenocarcinoma
E Cullen, JF Silverman, MA Khalifa, N Ismiil, V Dube, S Nofech-Mozes, Z Ghorab, RS Saad. Allegheny General Hospital, Pittsburgh; Sunnybrook Health Sciences Centre, Toronto, Canada
Background: There is growing evidence supporting the role of microvessel density as an important predictor of tumor behavior in a number of human malignancies. Endoglin (CD105), a member of transforming growth factor beta1 receptor complex, has been shown to be a more useful marker than panendothelial markers. However, there is limited data regarding the prognostic significance of angiogenesis evaluated with endoglin in cervical adenocarcinoma. In this study, we investigated endoglin as an endothelial marker of angiogenesis in endocervical adenocarcinoma.
Design: Surgical specimens from 45 consecutive patients with endocervical adenocarcinoma treated with radical hysterectomy and surgical staging were reviewed. Selected tumor blocks were immunostained for CD31 and endoglin. Positively stained microvessels (MV) were counted in densely vascular foci (hot spots) at x400 field in each specimen (=0.17 mm2). Results were expressed as the highest number of MV count identified within any single field and correlated with other prognostic parameters and survival.
Results: Endoglin identified MV in all cases with a mean count of 15+7/0.17 mm2, while CD31 was positive in 43/45 (96%); with a mean count of 24+11/0.17 mm2 with significant correlation (P< 0.05). Both endoglin and CD31 MV counts correlated significantly with depth of invasion, circumferential involvement, lymphovascular invasion and tumor stage (r=0.63 and 0.41; 0.43 and 0.39; 0.56 and 0.40; 0.40 and 0.31; respectively, P<0.05). Only endoglin MV density was correlated with tumor size (r=0.47, P< 0.01), recurrence (r=0.40, P< 0.001) and distant metastases (r=0.44; P< 0.001). It was also associated with poor overall survival (Log Rank, P =0.032).
Conclusions: Our study shows that angiogenesis plays an important role in the progression of endocervical adenocarcinoma. By staining the proliferating MV, endoglin is a specific and a sensitive marker for tumor angiogenesis than commonly used pan-endothelial markers such as CD31.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 187, Tuesday Morning