MELF pattern of myometrial invasion and role in possible endometrial cancer diagnostic pathway: A systematic review of the literature

Prodromidou, Anastasia; Vorgias, George; Bakogiannis, Konstantinos; Kalinoglou, N; Iavazzo, Christos

doi:10.1016/j.ejogrb.2018.09.036

Cited by 17 publications

(13 citation statements)

References 28 publications

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“…Tumors with diffusely infiltrative patterns of invasion are the most frequent and this is in agreement with other results [11]. However, MELF pattern, which has been linked with myometrial invasion, LVSI and https://doi.org/10.37358/RC.20.9.8337 lymph node involvement [11][12][13] and is currently considered a significant prognostic pattern, was represented in our study in only one patient.…”

Section: Resultssupporting

confidence: 92%

Molecular Subgroups of Endometrial Carcinoma in Romanian Patients

Evsei¹,

Birceanu-Corobea²,

Csonka³

et al. 2020

Rev. Chim.

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Molecular classification of endometrial carcinoma (EC) has represented a breakthrough ever since the TCGA (The Cancer Genome Atlas) project published it in 2013. Four distinct molecular subgroups were recognized based on somatic copy number alterations and tumor mutational burden: POLE (polymerase-epsilon) ultramutated, MSI (microsatellite instability) hypermutated (MSI-H), copy number low (CNL) and copy number high (CNH). However, implementing a standardized algorithm in current practice is far from being definitive. Our purpose in this study was to determine different molecular subgroups in a cohort of Romanian patients using cost effective and available immuno-histochemistry markers and outline statistical associations with different parameters. Tissue microarrays encompassing 50 cases with previously diagnosed ECs were tested for ER, PR, HER2, p53, MSH6 and PMS2 and results showed 68% MSI-H cases with statistical correlation with tumor size ] 2 cm (p=0.028) and no association with overall survival. CNH ECs were reported in 26% of cases and showed important statistical significance with TILs (p=0.041) and no correlations with overall survival. The CNL subgroup was reported in 74% of ECs cases and showed statistical significance with the histopathological subtype (p=0.006), pT (removal of primary tumor according to AJCC/UICC convention) (p=0.033), risk category according to ESMO (European Society of Medical Oncology) criteria (p=0.022) and ER expression (p=0.002). Five-year overall survival was 84%. Molecular classification is an important additional tool in current pathology guidelines for reporting ECs, but it is not currently standardized or available in all laboratories. Its importance in evolving treatment strategies for this disease is well documented so we strongly recommend routine testing for molecular prognostic factors.

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Section: Resultssupporting

confidence: 92%

Molecular Subgroups of Endometrial Carcinoma in Romanian Patients

Evsei¹,

Birceanu-Corobea²,

Csonka³

et al. 2020

Rev. Chim.

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“…Even though patients with POLE-mutant EC have an excellent prognosis, when we considered POLE mutation together with MELF pattern invasion, we found that MELF pattern invasion was associated with a significant increase in tumor recurrence or progression risk among patients with POLE mutation, whereas such an association was not present in POLE-wild-type patients. Many studies have indicated that the MELF pattern of myometrial invasion plays a critical role in lymphovascular space invasion and lymph node metastasis, however, its implication in survival and recurrence is ill defined [28][29][30]. Thus, according to our results, MELF pattern invasion might be a possible predictor of tumor recurrence or progression risk in the POLE-mutant subtype.…”

Section: Discussionmentioning

confidence: 50%

POLE mutation combined with microcystic, elongated and fragmented (MELF) pattern invasion in endometrial carcinomas might be associated with poor survival in Chinese women

Wang

Dong

et al. 2020

Gynecologic Oncology

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“…However, our inclusion and exclusion criteria eliminated any potential bias. The systematic review of Prodromidou et al [30] revealed that most of the published literature describing the role of MELF patterns in patients’ survival did not study large cohorts of patients, which may be a factor in the inconclusive observations.…”

Section: Discussionmentioning

confidence: 99%

High Expression of Galectin-1, VEGF and Increased Microvessel Density Are Associated with MELF Pattern in Stage I-III Endometrioid Endometrial Adenocarcinoma

Зиновкин

Ачинович

Zubritskiy

et al. 2019

J Pathol Transl Med

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Although most early-stage endometrioid endometrial adenocarcinomas (EA) have an excellent prognosis, a minority of lowgrade disease cases may have an aggressive clinical course. 1-4 EAs are histologically heterogeneous with myometrial invasion characterized by a microcystic, elongated and fragmented (MELF) pattern surrounded by myxoid and inflamed stroma. MELF pattern was first described by Murray et al. in 2003, 5 but only a few studies since have reported on the biological potential of this histopathological lesion. Most published studies have focused on the clinicopathological and immunohistochemical parameters of the cancer microenvironment in relation to the MELF pattern. However, the role of microvessels and angiogenic factors such as galectin-1 and vascular endothelial growth factor (VEGF) in the MELF pattern has not been described. Furthermore, the role of the specific fibromyxoid stromal changes in the prognosis of survival of patients with EA remains unclear. 6 The MELF pattern is known to be associated with lymphovascular invasion and lymph node metastasis, but

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MELF pattern of myometrial invasion and role in possible endometrial cancer diagnostic pathway: A systematic review of the literature

Cited by 17 publications

References 28 publications

Molecular Subgroups of Endometrial Carcinoma in Romanian Patients

Molecular Subgroups of Endometrial Carcinoma in Romanian Patients

POLE mutation combined with microcystic, elongated and fragmented (MELF) pattern invasion in endometrial carcinomas might be associated with poor survival in Chinese women

High Expression of Galectin-1, VEGF and Increased Microvessel Density Are Associated with MELF Pattern in Stage I-III Endometrioid Endometrial Adenocarcinoma

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