Tumor angiogenesis, macrophages and mast cell microdensities in endometrioid endometrial carcinoma

The present study aimed to observe and compare the values of microvessel density (MVD), mast cell microdensity (McMD) and macrophage microdensity (MphMD) in intratumoral areas compared with the advancing edges, and to assess any correlations between these values and the degree and stage of the neoplasia. The cases of 52 patients who were diagnosed with endometrial carcinoma between 2003 and 2011 were analyzed, the majority of which were in the first stage of the disease (44 cases). Double sequential immunohistochemistry and the hot-spot counting method were used to assess the MVD (CD105⁺ MVD), McMD [tryptase⁺ (Try⁺) McMD] and MphMD (CD68⁺ MphMD) densities. The χ² test, paired Student's t-test and the Pearson correlation index were used to assess the significance of the results. A weak correlation was observed at the advancing edge only, between CD105⁺ MVD and Try⁺ McMD (P=0.039). No significant differences were identified in the analysis of CD105⁺ MVD, Try⁺ McMD and CD68⁺ MphMD, but wide variations in their distribution were observed. Depending on the tumor stage, CD105⁺ MVD exhibited an intratumoral, indirect correlation with Try⁺ McMD for stage IA (P=0.026) and II (P=0.013) tumors. CD105⁺ MVD presented an indirect correlation with CD68⁺ MphMD in stage IB tumors (P=0.016) and at the advancing edge for well-differentiated tumors (P=0.027). An analysis of the correlation between CD68⁺ MphMD and Try⁺ McMD indicated that the intratumoral levels of CD68⁺ MphMD were directly proportional with the Try⁺ McMD values in well-differentiated (P=0.005) and stage II (P=0.012) tumors, while at the front of the invasion, this correlation was indirect (P=0.010) in stage II tumors. In endometrioid endometrial carcinoma (EEC), angiogenesis is at its most active at the advancing edge of the tumor, where mast cells play a pro-angiogenic role.