Microvascular Density In The Evaluation Of Neoplastic Cervical Lesions

Abstract Aims: To evaluate the diagnostic value of CD31 immunohistochemical (IHC) investigation in neoplastic lesions of the uterine cervix among patients of Hospital Tuanku Jaafar (HTJ), Seremban, Malaysia. Methods: This is a retrospective correlation study constituting 105 cases in total, selected over a 10-year period from March 2005 to March 2015. It was conducted in the research laboratories of the International Medical University, Bukit Jalil, and sample collection was performed at the Department of Pathology of HTJ. Patients diagnosed with “cervicitis”, “cervical intraepithelial neoplasia (CIN) grades I through III” and “squamous cell carcinoma” were included in the study. Non-epithelial cervical lesions were excluded. Demographic data and representative paraffin blocks with H&E slides of each case were reviewed. Sectioned samples were stained immunohistochemically with CD31 to mark endothelial cells. Staining density of the microvessels was then observed under high power. The average of three hotspots per sample was obtained and recorded as the microvascular density (MVD) score. Means for each diagnostic group were tabulated and results were statistically analysed using SPSS version 18. Results: Patients’ age ranged from 23 to 85 years with mean of 49.2 years. Cases of carcinoma were most prevalent among 60-69 year-olds. Mean MVD score increases with increasing dysplasia from cervicitis (8.84), CIN (12.57) to carcinoma cervix (29.6). Conclusion: MVD CD31 immunohistochemistry investigation can aid in differentiating cervical lesions; benign, intraepithelial neoplasia and invasive malignancy, and could play an adjuvant role in diagnosing neoplastic cervical lesions.