Clinical and ultrasound characteristics of the microcystic elongated and fragmented (MELF) pattern in endometrial cancer according to the International Endometrial Tumor Analysis (IETA) criteria
| Autor: | Vaclav Hejda, M. Angela Pascual, G. Opolskiene, Kristyna Nemejcova, Francisco Tresserra, Denis Nastic, Francesca Bono, L.A. Haak, Robert Fruscio, Elisabeth Epstein, Antonia Carla Testa, Linda S E Eriksson, Dorella Franchi, Raimundas Meskauskas, Mariacristina Ghioni, Daniela Fischerova, Joseph W. Carlson, Gian Franco Zannoni, F. Frühauf |
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| Přispěvatelé: | Eriksson, L, Nastic, D, Frühauf, F, Fischerova, D, Nemejcova, K, Bono, F, Franchi, D, Fruscio, R, Ghioni, M, Haak, L, Hejda, V, Meskauskas, R, Opolskiene, G, Pascual, M, Testa, A, Tresserra, F, Zannoni, G, Carlson, J, Epstein, E |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
diagnostic imaging Hysterectomy Endometrium 03 medical and health sciences 0302 clinical medicine medicine Medical imaging Humans Neoplasm Invasiveness Adenomyosis Prospective Studies neoplasm staging Lymph node Aged Endometrial Tumor 030219 obstetrics & reproductive medicine business.industry Endometrial cancer Advanced stage Ultrasound Obstetrics and Gynecology Histiocytes ultrasonography Middle Aged Prognosis medicine.disease MELF Endometrial Neoplasms medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Myometrium Lymph Node Excision Female endometrial neoplasm Lymph Nodes Radiology business Follow-Up Studies |
| Popis: | ObjectivesTo describe sonographic features of the microcystic elongated and fragmented (MELF) pattern of myometrial invasion (MI) using the International Endometrial Tumor Analysis (IETA) criteria; to assess the effect of the MELF pattern on preoperative ultrasound evaluation of MI; and to determine the relationship of the MELF pattern to more advanced stage (≥ IB) and lymph node metastases in women with endometrioid endometrial cancer.Methods/materialsWe included 850 women with endometrioid endometrial cancer from the prospective IETA 4 study. Ultrasound experts performed all ultrasound examinations, according to the IETA protocol. Reference pathologists assessed the presence or absence of the MELF pattern. Sonographic features and accuracy of ultrasound assessment of MI were compared in cases with the presence and the absence of the MELF pattern. The MELF pattern was correlated to more advanced stage (≥IB) and lymph node metastases.ResultsThe MELF pattern was present in 197 (23.2%) women. On preoperative ultrasound imaging the endometrium was thicker (p = 0.031), more richly vascularized (p = 0.003) with the multiple multifocal vessel pattern (p < 0.001) and the assessment of adenomyosis was more often uncertain (p < 0.001). The presence or the absence of the MELF pattern did not affect the accuracy of the assessment of MI. The MELF pattern was associated with deep myometrial invasion ≥ 50% (p < 0.001), cervical stromal invasion (p = 0.037), more advanced stage (≥ IB) (p < 0.001) and lymph node metastases (p = 0.011).ConclusionsTumors with the MELF pattern were slightly larger, more richly vascularized with multiple multifocal vessels and assessment of adenomyosis was more uncertain on ultrasound imaging. The MELF pattern did not increase the risk of underestimating MI in preoperative ultrasound staging. Tumors with the MELF pattern were more than twice as likely to have more advanced stage (≥ IB) and lymph node metastases. |
| Databáze: | OpenAIRE |
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