الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Endometrial carcinoma is the most common type of female genital tract. The most important prognostic factors in endometrial cancer are histological type, grade, lymph node status, deep myometrial invasion, estrogen receptor (ER) and progesterone receptor (PR) status, tumor stage and Tumor DNA ploidy. Clinical and pathological observations suggest that for many carcinomas, transport of tumor cells via lymphatics is a common pathway of initial dissemination, with patterns of spread via afferent lymphatics following routes of natural drainage. It is unclear whether lymphatic dissemination occurs as a result of cancer cell infiltration of pre-existing lymphatic vessels or newly formed ones, originating from those of the normal surrounding tissues. Lymph-angiogenesis has been difficult to investigate because there was a lack of specific antibodies recognizing the lymphatic endothelium. D2-40 was reported to be a specific marker for lymphatic endothelium in normal and neoplastic tissue.
The aim of this work was to assess intratumoral and peritumoral lymphatic microvascular density (LMVD) in endometrial carcinomas and to investigate their association with classical pathological factors, risk of lymph node (LN) metastasis and theirrelation to other prognostic parameters.
This study was a prospective study done in tertiary education and research hospital (El-Shatby Maternity University Hospital ) on sixty patients presented with endometrial carcinoma underwent complete surgical staging, histopathological examination reporting tumor histotype, tumor grade, tumor stage, LVSI, adnexal infiltration, lymph node status, degree of myometrial infiltration and cytological examination of peritoneal fluid aspirate.Tumor sections mounted onto positively charged slides were immunostained using monoclonal antibodies against Podoplanin. (A marker specifically expressed in lymphatic endothelial cells) to highlight lymphatic vessels.Stained histologic sections were analyzed using standard light microscopy. Under low magnification, the most vascularized intratumoral and peritumoral areas were identified. The numbers of immunostained lymphatic vessels found in 10 hot spot areas at 400X magnification were counted to calculate peritumoral and intratumoral lymphatic microvessel density (LMVD).
All the patients were scheduled for follow up visits three, six, and twelve months postoperatively looking for stump and pelvic recurrence by physical and gynecological examination. Multi-slice CT scanning of the abdomen and pelvis was done at six and twelve month intervals.