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Volume : 37 Issue : 2 Year : 2022



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Prognositc Significance of Microcystic Elongated and Fragmanted (MELF) Myometrial Invasion Pattern: A Retrospective Study [Medeniyet Med J]
Medeniyet Med J. 2022; 37(3): 212-219 | DOI: 10.4274/MMJ.galenos.2022.40336  

Prognositc Significance of Microcystic Elongated and Fragmanted (MELF) Myometrial Invasion Pattern: A Retrospective Study

Oguzhan OKCU1, Gokce ASKAN1, Bayram SEN2, Cigdem OZTURK1, Seda DUMAN OZTURK1, Gulname FINDIK GUVENDI3
1Recep Tayyip Erdogan University Training and Research Hospital, Clinic of Pathology, Rize, Turkey
2Recep Tayyip Erdogan University Training and Research Hospital, Clinic of Biochemistry, Rize, Turkey
3Recep Tayyip Erdogan University Faculty of Medicine, Department of Pathology, Rize, Turkey

Objective: Endometrioid endometrial carcinomas (EEC) are the most commonly diagnosed malignancies of the female genital tract. Myometrial invasion depth is one of the most significant pathological prognostic parameters. Different morphological invasion patterns have been characterized. This study aimed to investigate the prognostic significance of the microcystic elongated and fragmented (MELF) myometrium invasion pattern in patients with EEC and its relationship with other clinicopathological parameters.
Methods: This study included 101 patients with EEC in our institution between 2011 and 2020. The MELF pattern was evaluated in hematoxylin-eosin-stained sections. Pan-cytokeratin staining was performed on paraffin-embedded blocks of lymph nodes for cases without lymph node metastasis.
Results: The MELF pattern was observed in 29 (29.8%) patients. It was significantly associated with lymphovascular invasion (p<0.001), pathologic stage (p=0.048), infiltrative pattern (p<0.001), and necrosis (p=0.005). No significant correlation was observed between the MELF pattern and overall and disease-free survival rates.
Conclusions: The MELF pattern is associated with other prognostic parameters, but its prognostic significance for survival has not been found. If the MELF pattern is observed in the hysterectomy material for cases without lymph node dissection during the first surgery, these patients may need additional surgery or adjuvant therapy due to the high risk of lymphovascular invasion and lymph node metastasis.

Keywords: Microcystic elongated and fragmented (MELF), endometrioid endometrial carcinomas, survival


MELF myometriyal invazyon paterninin prognostik önemi: Retrospektif bir çalışma

Oguzhan OKCU1, Gokce ASKAN1, Bayram SEN2, Cigdem OZTURK1, Seda DUMAN OZTURK1, Gulname FINDIK GUVENDI3
1Recep Tayyip Erdoğan Üniversitesi Eğitim ve Araştırma Hastanesi, Tıbbi Patoloji, Rize, Türkiye
2Recep Tayyip Erdoğan Üniversitesi Eğitim ve Araştırma Hastanesi, Biyokimya, Rize, Türkiye
3Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Patoloji Ana Bilim Dalı, Rize, Türkiye

Amaç: Endometrioid endometriyal karsinomlar (EEK) kadın genital sistemin en sık karşılaşılan maligniteleridir. Myometrium invazyon derinliği en önemli patolojik prognostik parametrelerden birisidir. Farklı morfolojik invazyon paternleri tanımlanmıştır. Biz çalışmamızda EEk olgularında mikrokistik elonge fragmante (MELF) myometirum invazyon paterninin prognostik önemini ve klinikopatolojik parametrelerle ilişkisini araştırmayı amaçladık.
Yöntemler: 2011-2020 yılları arasında kurumumuzda EEK tanısı alan 101 hasta çalışmaya dahil edildi. Hematoksilen eozin kesitlerde MELF paterni değerlendirildi. Lenf nodu metastazı izlenmeyen olgularda lenf nodu bloklarına pan-sitokeratin uygulandı.
Bulgular: Yirmi dokuz hastada (%29,8) MELF paterni izlendi. MELF paterni lenfovasküler invazyon (p<0,001), patolojik evre (p=0,048), infiltratif patern (p<0,001), ve nekroz (p=0,005) ile anlamlı ilişkili izlendi. Genel ve hastalıksız sağkalımda MELF paterni istatistiksel olarak anlamlı ilişkili izlenmedi.
Sonuçlar: MELF paterni diğer prognostik parametrelerle ilişkili olup tek başına prognostik önemi saptanmamıştır. Ancak ilk cerrahi sırasında lenf nodu diseksiyonu yapılmayan EEK hastalarında histerektomi materyalinde MELF paterni saptanması durumunda yüksek lenfovasküler invazyon ve lenf nodu metastaz riski nedeniyle ek cerrahi işlem ya da adjuvan terapi kararında MELF paterni varlığının dikkate alınması gerektiğine inanıyoruz.

Anahtar Kelimeler: Mikrokistik elonge fragmante (MELF), endometrioid endometrial kanser, sağkalım


Oguzhan OKCU, Gokce ASKAN, Bayram SEN, Cigdem OZTURK, Seda DUMAN OZTURK, Gulname FINDIK GUVENDI. Prognositc Significance of Microcystic Elongated and Fragmanted (MELF) Myometrial Invasion Pattern: A Retrospective Study. Medeniyet Med J. 2022; 37(3): 212-219

Corresponding Author: Oguzhan OKCU, Türkiye


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