Microcystic,elongated,and fragmented pattern of invasion in relation to histopathologic and clinical prognostic factors in endometrioid endometrial adenocarcinoma

Objective: to investigate the association of microcystic,elongated,and fragmented (melf) pattern of invasion with prognostic factors in endometrioid endometrial adenocarcinoma (eea). material and methods: stained tissue sections from 83 cases of eea operated by the same gynecologic oncologist were reviewed to identify cases showing melf-type invasion in this retrospective study. the association of melf pattern with age,tumor grade,depth of myometrial invasion,and presence of lymphovascular space invasion (lvsi) was analyzed. results: figo grade 2 and grade 1 tumors were evident in 53.0% and 38.6% of patients,respectively. depth of myometrial invasion was <50% in 72.0% of patients,and lvsi was absent in 77.1%. melf pattern was confirmed in 35 (42.2%) patients. presence of melf pattern was associated with significantly higher mean ± standard deviation age (62.9±6.9) years vs. 58.9±9.1 years,p=0.033),and found to be more likely in patients with high-grade tumor (figo grade iii; 85.7% vs. 14.3%,p<0.001),deep (≥50%) myometrial invasion (78.3% vs. 21.7%,p<0.001),and presence of lvsi (94.7% vs. 5.3%,p<0.001) as compared with absence of melf pattern. conclusion: in conclusion,our findings revealed a high rate of melf pattern among patients with eea alongside the association of melf pattern with poor prognostic factors such as high grade tumor,deep myometrial invasion,and lvsi. © 2017 by the turkish-german gynecological education and research foundation.