Background: This study was designed to evaluate the significance of tumor angiogenesis and angiogenic factors such as hepatocyte growth factor (HGF) and c-Met in determining the prognoses of 93 patients with endometrial carcinoma.
Methods: By immunohistochemical staining, this retrospective study investigated tumor angiogenesis, HGF expression, and c-Met expression, using one tissue slide that was representative of the invasive edge of the tumor. To evaluate tumor angiogenesis, the microvessels within the primary endometrial carcinoma were highlighted by staining their endothelial cells immunohistochemically for von Willebrand factor (VWF). The microvessels were then counted in the most intense areas of neovascularization. HGF and c-Met were identified with specific antibodies. Tumor angiogenesis, HGF expression, and c-Met expression were correlated with both the prognostic variables for and the survival of endometrial carcinoma.
Results: A high microvessel count (> or = 110 in a 0.90 mm2 area) was significantly correlated with surgical Stage III and IV, histologic Grade 3, positive lymph node involvement, and shorter patient survival. Expression of c-Met was significantly correlated with surgical Stage III and IV, histologic Grade 3, and shorter survival. HGF expression was significantly correlated with surgical Stage III and IV by semiquantitative analysis. Multivariate analysis showed that surgical Stage III and IV, histologic Grade 3, the score for myometrial invasion > 1/2, and a high microvessel count were independent indicators of the prognoses of patients with endometrial carcinoma.
Conclusions: Both tumor angiogenesis, measured by the microvessel count, and c-Met expression were significant prognostic indicators for patients with endometrial carcinoma.