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The intent of this research was to identify if the degenerative changes within arteries in the endometrium (endometrial angiopathies) correlate with degenerative changes in the uterine arteries and can be used as a predictor of increased risk for uterine artery rupture (UAR). With this objective specimens from 20 mares that died from uterine artery rupture and 21 control mares that died from unrelated causes were obtained from cases submitted to the University of Kentucky Veterinary Diagnostic Laboratory (UKVDL) over a two-year period. Postmortem specimens of each mare were collected from the left and right uterine arteries at the origin, bifurcation, and distal to the bifurcation as well as full thickness uterine wall sections at five different sites. An additional sample was taken from the uterine artery at the site of rupture in the affected mares. Tissue samples were immersed in 10% neutral buffered formalin, routinely processed, and stained with hematoxylin and eosin, Masson’s Trichrome, and Verhoeff´s Van Gieson histochemical stains as well as a smooth muscle-actin immunohistochemical marker. Elastosis, fibrosis, and vascular smooth muscle cell degeneration were identified in this study as potential contributors of vascular degeneration and a scoring system was developed to differentiate the degrees of severity of these specific degenerative changes within the intima and media of the vascular wall. Based on the scoring system, sections of uterine arteries and endometrial arterioles were blindly examined and the scored changes recorded for statistical analysis. Although the degenerative changes in endometrial and uterine arteries were similar within each group, the results could not not be used to predict an increased risk for UAR. Furthermore, we determined the major changes in vascular pathology of the affected uterine arteries and show there is a significant difference in degenerative changes between specific layers of the vascular wall.

Orientador: João Carlos Pinheiro Ferreira / Banca: Nereu Carlos Prestes / Banca: Sony Dimas Bicudo / Banca: Inês Cristina Giometti / Banca: Jeanne Broch Siqueira / Resumo: O objetivo deste foi avaliar os efeitos da utilização de implantes subcutâneos de Deslorelina (agonista de GnRH-Suprelorin®) por 70 dias sob a dinâmica folicular, secreção de FSH, LH e P4 e, a expressão gênica e proteica dos receptores endometriais de estrógeno e (E R e E R), de progesterona isoformas A e B (PABR e PBR) e de ocitocina (OTR) em vacas Nelore (Bos taurus indicus). Foi sincronizada a ovulação de 15 vacas Nelore com escore de condição corporal (ECC) 3 e, no D0 foram aleatoriamente selecionados 7 animais para serem submetidos a implantação subcutânea de Deslorelina por 70 dias. O exame ultra-sonográfico foi realizado para caracterização da dinâmica folicular e os folículos foram classicados em classes: I (< 0,4 cm), II (0,4-0,6cm) e III (> 0,6cm). Amostras de sangue foram coletadas para mensuração das concentrações plasmáticas de FSH, LH e P4. A pulsatilidade e os picos de LH foram determinados a partir de amostras sanguíneas coletadas a cada 15 minutos por 6 horas em 4 vacas escolhidas aleatoriamente nos D20 e D62. A mensuração da expressão proteica dos E R, E R, PABR e PBR no epitélio glandular e estroma uterino foram mensurados por meio da técnica da imunoistoquímica e, a expressão gênica dos E R, E R, PABR e OTR foi avaliada com auxílio da técnica de qRT-PCR, ambas... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The objective this study is to evaluate the effects of subcutaneous implant Deslorelin (GnRHa-Suprelorin®) by 70 days on the endocrine dynamic, the follicular development and, gene and protein expression of endometrial receptors of estrogen and (E R and E R), progesterone isoforms A and B (PABR and PBR), and oxytocin (OTR) of Nelore (Bos taurus indicus) cows . Ovulation of 15 Nelore cows with BCS 3 was synchronized following of implantation of Deslorelin in 7 animals for 70 days. During this period, the ovaries were scanned by ultrasonography to characterize the follicular dynamics, where the follicles were divided in class: I (< 0.4 cm), II (0.4-0.6 cm) and III (> 0.6 cm). Blood samples were collected before of each ultrasonographic exam for later measurement of plasma FSH, LH and P4. The assessment of LH pulsatile secretion was measured on blood samples collected every 15 minutes for six hours through the jugular catheterization in fourrandomly chosen cows on D20 and D62. The protein expression of E R and E R, PABR and PBR of endometrial glandular epithelial and stromal was measured using the technique of immunohistochemistry and the quantification of gene expression of E R, E R, PABR and OTR by qRT-PCR technique from fragments collected through endometrials biopsies on days 0, 4, 20 and 27. Others two samples of endometrium were used for. The comparison between the moments of the measures was performed using the nonparametrics tests of the Friedman and Fisher's Exact. The relationship between the results of follicular dynamics, gene and protein expression was performed by Pearson correlation, all with a significance level of 0.05. During the 70 days of implantation of Deslorelin neither animal ovulated, indicating that the preovulatory peak of LH was abolished. The maximum number of follicles... (Complete abstract click electronic access below) / Doutor

Orientador: Julio Lopes Sequeira / Banca: Alessandre Hataka / Banca: Noeme Sousa Rocha / Resumo: O presente trabalho teve por objetivos avaliar os graus de fibrose endometrial das éguas, especificando por técnicas histoquímicas os tipos de colágeno e sua proporção nas lesões crônicas, além de verificar por método imunoistoquímico a expressão e distribuição das metaloproteinases (MMP) 2 e 9 e um dos seus inibidores - TIMP-1 - nos processos crônicos endometriais. Foram utilizadas 82 biópsias endometriais classificadas histologicamente de acordo com Kenney e Doig (1986) e segundo as definições de Ricketts & Alonso (1991) para endometrite crônica infiltrativa e endometrose. A avaliação do colágeno foi realizada pelos métodos histoquímicos Tricrômico de Masson, Reticulina e Picrosirius Red. Estudo morfométrico da fibrose periglandular foi realizado utilizando-se a técnica histoquímica do Picrosirius Red. Os resultados mostraram que nos endométrios portadores de endometrite severa há deposição de colágeno do tipo III e do tipo I, sendo este predominante. Não houve diferença significativa na extensão da fibrose periglandular entre as endometrites crônicas infiltrativas e endometroses. Tanto no endométrio hígido como nas endometrites crônicas foi observada imuno-reatividade para as enzimas estudadas. A reação imunoistoquímica para MMP-2 foi localizada no epitélio luminal, glandular, parede vascular e células estromais. MMP-9 e TIMP-1 mostraram marcação mais difusa, sendo também observadas nas células inflamatórias e endoteliais. / Abstract: The aim of this study was to evaluate the degrees of endometrial fibrosis in mares, specifying the types of collagen in the chronical lesions and its ratio by histochemical analysis and, the expression and distribution of matrix metalloproteinases (MMP) 2, -9 and one of its inhibitors - TIMP-1 - in the endometrial chronic processes by means of immunohistochemistry. Eighty-two biopsies of chronic endometritis were classified according to Kenney and Doig (1986) and definitions of Ricketts & Alonso (1991) for chronic infiltrative endometritis and endometrosis. The collagen evaluation was made by Massonþs trichrome, Reticulin and Picrosirius Red staining methods. The endometrial periglandular fibrosis morfometric analysis was carried out by using Picrosirius Red stained slides. Deposition of type III collagen and type I collagen was seen in severe endometritis with type I predominance. The chronic infiltrative endometritis and endometrosis didn't show significant difference in the extension of periglandular fibrosis. Immunoreactivity of MMP-2, MMP-9 and TIMP-1 was detected in healthy endometrium as in severe chronic endometritis. The luminal epithelium, glandular epithelium, vascular wall and stromal cells expressed MMP-2. MMP-9 and TIMP-1 had shown diffuser marking, and were as well observed in the inflammatory cells and the endothelium. / Mestre

INTRODUÇÃO: A metástase linfonodal em adenocarcinomas de endométrio reduz significativamente as taxas de sobrevida. Poucos estudos relacionando a microdensidade vascular linfática (MDVL) intratumoral e sobrevida em adenocarcinomas endometriais estão disponíveis atualmente. OBJETIVO: O propósito deste estudo foi avaliar a microdensidade vascular linfática intratumoral dos adenocarcinomas de endométrio e investigar a sua associação com fatores patológicos clássicos, metástase linfonodal e sobrevida. MÉTODOS: Cinquenta e sete pacientes com adenocarcinoma de endométrio, diagnosticadas entre 2000 a 2008 submetidas a estadiamento cirúrgico completo e avaliação da MDVL intratumoral e outras variáveis histológicas. Os micro vasos linfáticos foram identificados através de reação imunoistoquímica utilizando um anticorpo monoclonal contra a podoplanina humana (clone D2-40) e avaliados pela contagem do número de vasos linfáticos marcados em 10 campos com maior densidade vascular em aumento de 400 vezes. A MDVL foi expressa pela média do número de vasos nestes 10 campos microscópicos de maior densidade vascular. A seguir, investigamos a associação entre MDVL com achados clínico-patológicos e prognóstico. Nossos resultados demonstraram que a média do número de vasos linfáticos contados em todos os casos variou de 0 a 4.7. O valor da mediana obtida da média da MDVL foi de 0,5 e foi definido como valor de corte entre baixa e alta MDVL. RESULTADOS: Identificamos baixa MDVL intratumoral em 27 (47,4%) pacientes e alta MDVL em 30 (52,6%) das pacientes. A elevada MDVL intratumoral foi associada com menor comprometimento linfonodal e casos fatais, menor infiltração miometrial e de anexos e menor comprometimento cervical e peritoneal. Não foi obtida associação entre MDVL e idade, tipo histológico pelo sistema da FIGO, invasão vascular ou comprometimento linfonodal. CONCLUSÃO: Nossos resultados mostram associação entre elevada MDVL intratumoral com fatores prognósticos favoráveis no câncer endometrial / INTRODUCTION: Lymph node metastasis in endometrial cancer significantly decreases survival rate. Few data on the influence of intratumoral lymphatic microvessel density (LMVD) on survival in endometrial cancer are available. OBJECTIVE: Our aim was to assess the intratumoral LMVD of endometrial adenocarcinomas and to investigate its association with classical pathological factors, lymph node metastasis and survival. METHODS: Fifty-seven patients with endometrial adenocarcinoma diagnosed between 2000 and 2008 underwent complete surgical staging and evaluation of intratumoral LMVD and other histologic variables. Lymphatic microvessels were identified by immunohistochemical staining using monoclonal antibody against human podoplanin (clone D2-40) and evaluated by counting the number of immunostained lymphatic vessels in 10 hot spot areas at 400X magnification. The LMVD was expressed by the mean number of vessels in these 10 hot spot microscopic fields. We next investigated the association of LMVD with the clinicopathologic findings and prognosis. Our results demonstrated that the mean number of lymphatic vessels counted in all cases ranged between 0 and 4.7. The median value of mean LMVD was 0.5, and defined the cut-off for low and high LMVD. RESULTS: We identified low intratumoral LMVD in 27 (47.4%) patients and high LMVD in 30 (52.6%) patients. High intratumoral LMVD was associated with lesser nodal involvement and fatal cases, lesser miometrial and adnaexal infiltration, and lesser cervical and peritoneal involvement. No association was seen between LMVD and age, FIGO staging histological type, vascular invasion, or lymph node involvement. CONCLUSION: Our results show association of high intratumoral LMVD with favorable prognosis in endometrial cancer

A proposta do experimento baseia-se na análise uterina de éguas distribuídas em três graus de fibrose, conforme estabelecido em 1978 por Kenney (grupo I – endométrio saudável; grupo II, endométrio saudável ou com poucas alterações; grupo III – endométrio com alterações severas). Portanto, o estudo tem por objetivo determinar o perfil da expressão gênica de possíveis genes causadores da fibrose, conhecidos pelo o envolvimento em outros órgãos e espécies, no endométrio de éguas classificadas com diferentes graus de saúde uterina. Uma amostra de tecido endometrial foi colhida por meio de biopsia uterina e seccionada em dois fragmentos para posterior análise. Para os exames laboratoriais, a primeira amostra foi destinada à avaliação histopatológica e a segunda à validação de genes-alvo por reação polimerase em tempo real (qPCR). No exame histopatológico, o grau de fibrose e fase do ciclo estral foram estimados para distribuir as fêmeas nos grupos, além disso, o histórico reprodutivo foi analisado e a partir dos dados do exame histopatológico e histórico foram selecionadas 20 fêmeas para realização do qPCR (grupo I = 11; grupo II = 6; grupo III = 3). A segunda amostra de tecido foi armazenada em nitrogênio líquido imediatamente após a coleta, sendo posteriormente armazenada em freezer -80°C. Após o processamento das amostras, a quantificação relativa da abundância dos transcritos de Fator de Transformação do Crescimento-β1 (TGF-β1), Fator de Crescimento do Tecido Conjuntivo (CTGF), Colágeno tipo I (COL-I), α actina de músculo liso (αSMA), Molécula de Adesão Intercelular-1 (ICAM-1), e Cluster de Diferenciação 147 (CD147) foi comparada entre os grupos. A expressão de αSMA (P = 0,78), COL-I (P = 0,57) e ICAM-1 (P = 0,98) não resultou em diferença entre os grupos; e a de TGF-β1 e CTGF foi maior no grupo I (P = 0,04). Nos casos de fibrose severa, a transcrição de mRNA de CD147 foi maior em comparação com o grupo I (P = 0,04). Desta forma, acredita-se que a partir da avaliação de genes expressos do endométrio de éguas com diferentes graus de fibrose pode ser possível identificar genes marcadores que aumentam a precisão da classificação previamente proposta. / The purpose of the experiment was to analyze the uterus of mares distributed in three degrees of fibrosis, as established by Kenney in 1978 (group I - healthy endometrium; group II, healthy endometrium or with few alterations; group III - endometrium with severe changes). A sample of endometrial tissue was collected by biopsy which was sectioned into two fragments for further analysis. For the laboratory tests, the first sample was used for histopathological evaluation and the second for the validation of target genes by quantitative polymerase chain reaction (qPCR). In the histopathological examination, the degree of fibrosis and phase of the estrous cycle were estimated to distribute the females into groups; in addition, the reproductive history was analyzed and from the obtained data of histopathological evaluation and history 20 mares were selected for qPCR (group I = 11; Group II = 6, group III = 3). The second tissue sample was stored in liquid nitrogen immediately after collection and stored in a freezer at -80 ° C. After the samples were processed, the relative abundance quantification of Transforming Growth Factor-β1 (TGF-β1), Connective Growth Factor (CTGF), α Smooth Muscle Actin (αSMA), Intercellular Adhesion Molecule-1 (ICAM-1), Type I Collagen (COL-I), and Differentiation Cluster 147 (CD147) was carried out. The expression of αSMA (P = 0.78), COL-I (P = 0.57) and ICAM-1 (P = 0.98) did not resulted in difference between the groups; and TGF-β1 and CTGF were higher in group I (P = 0.04). In severe cases of fibrosis, CD147 mRNA transcription was higher in comparison to the group I (P = 0.04). Thus, it is believed that from the evaluation of expressed endometrial genes in the mare with different degrees of fibrosis it may be possible to identify marker genes that increase the accuracy of the previously proposed classification.

Le cancer de l’endomètre est le plus fréquent des cancers gynécologiques pelviens. L’envahissement ganglionnaire constitue l’un des principaux facteurs pronostiques mais le rôle des curages ganglionnaires reste débattu.Nous avons construit le score PREGE (Prédiction du Risque d’Envahissement Ganglionnaire dans le cancer de l’Endomètre), à partir d’une base de données de près de 20000 cancers de l’endomètre, après la sélection de caractéristiques individuelles (race et âge) et tumorales définitives, obtenues sur la pièce d’hystérectomie (type, grade et extension locale) significativement associées à l’existence de métastase ganglionnaire. Le score PREGE a été validé sur une base de données multicentrique française (AUC dans les populations de développement et de validation de 0,80 et 0,79 respectivement). Le score était correctement calibré.En utilisant les données préopératoires (IRM et biopsie d’endomètre), les capacités de discrimination du score PREGE étaient conservées. Différents seuils d’intérêt pour la décision clinique ont été définis. Avec un seuil de 100 points, la valeur prédictive négative était de 100%.Dans aucun quantile du score PREGE, la survie spécifique n’était supérieure chez les patientes ayant eu une lymphadénectomie. Toutefois, avec un seuil prédit d’envahissement ganglionnaire supérieur à 20%, nous avons mis en évidence un bénéfice de la lymphadénectomie emportant au moins 10 ganglions.L’utilisation du score PREGE pour la sélection des patientes atteintes d’un cancer de l’endomètre candidates à une lymphadénectomie pourrait permettre de réduire le recours à cette intervention morbide sans altérer la survie spécifique / Endometrial cancer is the most common malignancy of the female genital tract. Lymph node metastasis is one of the most important prognostic factors. However, the therapeutic role of lymphadenectomy is still debated.We developed the score PREGE, able to predict lymph node metastasis based on pathological hysterectomy characteristics in endometrial cancer. Data from almost 20,000 patients who underwent hysterectomy and lymphadenectomy were analyzed and significant prognostic features were selected: final pathological characteristics (histologic type, grade and primary site tumoral extension) and patients’ characteristics (age and race). In a French multicentric cohort, the nomogram showed good discrimination (AUC=0.79 ) and was well calibrated.Lymph node metastasis prediction by the score using preoperative data was as accurate as that obtained using the final tumor characteristics. With a cut-off value of 100 points for the total score, the negative predictive value was 100%.Patients were clustered into quintiles according to their lymph node metastasis probability. The cancer related survival was compared based on whether patients underwent lymphadenectomy. In the five quintile groups, the specific survival rate was significantly higher in the patients who did not undergo lymphadenectomy. However, when lymph node letastatic probabilityexceeded 20%, specific survival was higher in patients in whom at least 10 lymph nodes were removed.PREGE score could be useful to select few patients who will really benefit from lymphadenectomy and avoid lymphadenectomy in most patients with endometrial cancer

Orientadores: Ilza Maria Urbano Monteiro, Cristina Laguna Benetti Pinto / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-11-07T13:19:02Z (GMT). No. of bitstreams: 1 Wolff_LuisPauloGalvao_D.pdf: 1651290 bytes, checksum: b102ec5f367b936722957672ca1edc59 (MD5) Previous issue date: 2011 / Resumo: Introdução: Após a menopausa, o ganho de peso e a distribuição dos depósitos de gordura podem estar alterados com o predomínio da gordura abdominal, favorecendo o aparecimento de doenças metabólicas e neoplásicas. O mecanismo pelo qual a obesidade promove o aparecimento destas doenças ainda não está totalmente esclarecido. No entanto, sugere-se que a produção de estrogênios, decorrentes da conversão dos andrógenos no tecido adiposo e os efeitos metabólicos relacionados à hiperinsulinemia, mediados pelo IGF-1, possam estar relacionados. Embora se espere que o endométrio após a menopausa esteja atrófico, existe uma proporção que mantém padrão proliferativo fraco, provavelmente como resposta ao baixo e constante estímulo estrogênico. O objetivo deste estudo é avaliar a associação existente entre a expressão de receptores esteróides, IGF-1, Bcl-2 e Ki-67 no endométrio, correlacionando-os com índice de massa corporal e resistência tecidual insulínica. Sujeitos e Métodos: Foi realizado estudo de corte transversal, sendo selecionadas 85 mulheres após a menopausa, do Centro de Atenção Integral à Saúde da Mulher (Caism - Unicamp) e do Hospital Dr. José de Carvalho Florence (São José dos Campos-SP). Foram avaliados os receptores endometriais para estrogênio (RE), progesterona (RP), fator de crescimento insulinóide 1 (IGF-1), Ki-67 e Bcl-2 na amostra endometrial obtida correlacionando-os com a resistência tecidual insulínica (RI) e índice de massa corporal (IMC). Os dados foram analisados através dos testes de Pearson e de Spearman, considerando-se o valor ? de 0,05. Resultados: Obtivemos 36,5% de mulheres com sobrepeso e 40% com obesidade. Não foi encontrada correlação estatística entre IMC com variável estudada. Observou-se expressão moderada e intensa para os RE (94,1%), RP (80%) e IGF-1R (78,8%) nas glândulas endometriais. A expressão do Ki-67 foi moderada e intensa em 75,3% e Bcl-2 em 65,9% das amostras. O índice HOMA-IR correlacionou-se com os RE (p=0,0402) e RP (p=0,0034). Os IGF-IR e RP se correlacionaram com CA (p=0,0189 e 0,0170) respectivamente. Observou-se correlação entre RE, RP e Ki-67 e Bcl-2. Conclusão: Mulheres após a menopausa apresentam grande expressão endometrial dos receptores estrogênicos, progestogênicos e IGF-1, independentemente do seu peso corporal ou do índice de massa corporal. Houve correlação entre os RE, RP e IGF-1R com marcadores de resitência tecidual insulínica / Abstract: Introduction: After menopause, weight gain and the distribution of fat deposits may be altered with a predominance of abdominal fat, favoring the development of metabolic diseases and cancer. The mechanism by which obesity promotes the onset of these diseases is not fully understood. However it is suggested that the production of estrogens, resulting from the conversion of androgens in adipose tissue and metabolic effects associated with hyperinsulinemia, mediated by IGF-1, may be related. While is hoped that the postmenopausal endometrium is atrophic, there is a proportion that maintains low proliferative index, probably in response to low estrogen and constant encouragement. The aim of this study is to evaluate the association between the expression of steroid receptors, IGF-1, Bcl-2 and Ki-67 in the endometrium, correlating them with body mass index and insulin resistance tissue. Subjects and Methods: Was conducted cross-sectional study, were 85 selected women after menopause, in the Center for Integral Attention to Women's Health (Caism - Unicamp) and the Hospital Dr. José de Carvalho Florence (São José dos Campos-SP). We evaluated the endometrial receptors for estrogen (ER), progesterone (PR), IGF-1, Ki-67 and Bcl-2 in endometrial sample obtained by correlating them with tissue insulin resistance (IR) and body mass index (BMI). Data were analyzed using Pearson tests and Spearman, considering ? value of 0.05. Results: We obtained 36.5% of overweight women and 40% were obese. We don't found statistical correlation between body mass index with no variable studied. We observed moderate to intense expression for ER (94.1%) PR (80%) and IGF-1R (78.8%) in the endometrial glands. The expression of Ki-67 was moderate and severe in 75.3% and Bcl-2 in 65.9% of samples. The index of HOMA-IR was correlated with the ER (p = 0.0402) and PR (p = 0.0034). The IGF-IR and PR were correlated with CA (p = 0.0189 and 0.0170) respectively. There was a correlation between ER, PR and Ki-67 and Bcl-2. Conclusion: Women after menopause have a great expression of endometrial estrogen, progestin and IGF-1 receptors, independent of their BMI. There was a correlation between the ER, PR and IGF-1R with tissue insulin resistance markers / Doutorado / Fisiopatologia Ginecológica / Doutor em Tocoginecologia

INTRODUÇÃO: A metástase linfonodal em adenocarcinomas de endométrio reduz significativamente as taxas de sobrevida. Poucos estudos relacionando a microdensidade vascular linfática (MDVL) intratumoral e sobrevida em adenocarcinomas endometriais estão disponíveis atualmente. OBJETIVO: O propósito deste estudo foi avaliar a microdensidade vascular linfática intratumoral dos adenocarcinomas de endométrio e investigar a sua associação com fatores patológicos clássicos, metástase linfonodal e sobrevida. MÉTODOS: Cinquenta e sete pacientes com adenocarcinoma de endométrio, diagnosticadas entre 2000 a 2008 submetidas a estadiamento cirúrgico completo e avaliação da MDVL intratumoral e outras variáveis histológicas. Os micro vasos linfáticos foram identificados através de reação imunoistoquímica utilizando um anticorpo monoclonal contra a podoplanina humana (clone D2-40) e avaliados pela contagem do número de vasos linfáticos marcados em 10 campos com maior densidade vascular em aumento de 400 vezes. A MDVL foi expressa pela média do número de vasos nestes 10 campos microscópicos de maior densidade vascular. A seguir, investigamos a associação entre MDVL com achados clínico-patológicos e prognóstico. Nossos resultados demonstraram que a média do número de vasos linfáticos contados em todos os casos variou de 0 a 4.7. O valor da mediana obtida da média da MDVL foi de 0,5 e foi definido como valor de corte entre baixa e alta MDVL. RESULTADOS: Identificamos baixa MDVL intratumoral em 27 (47,4%) pacientes e alta MDVL em 30 (52,6%) das pacientes. A elevada MDVL intratumoral foi associada com menor comprometimento linfonodal e casos fatais, menor infiltração miometrial e de anexos e menor comprometimento cervical e peritoneal. Não foi obtida associação entre MDVL e idade, tipo histológico pelo sistema da FIGO, invasão vascular ou comprometimento linfonodal. CONCLUSÃO: Nossos resultados mostram associação entre elevada MDVL intratumoral com fatores prognósticos favoráveis no câncer endometrial / INTRODUCTION: Lymph node metastasis in endometrial cancer significantly decreases survival rate. Few data on the influence of intratumoral lymphatic microvessel density (LMVD) on survival in endometrial cancer are available. OBJECTIVE: Our aim was to assess the intratumoral LMVD of endometrial adenocarcinomas and to investigate its association with classical pathological factors, lymph node metastasis and survival. METHODS: Fifty-seven patients with endometrial adenocarcinoma diagnosed between 2000 and 2008 underwent complete surgical staging and evaluation of intratumoral LMVD and other histologic variables. Lymphatic microvessels were identified by immunohistochemical staining using monoclonal antibody against human podoplanin (clone D2-40) and evaluated by counting the number of immunostained lymphatic vessels in 10 hot spot areas at 400X magnification. The LMVD was expressed by the mean number of vessels in these 10 hot spot microscopic fields. We next investigated the association of LMVD with the clinicopathologic findings and prognosis. Our results demonstrated that the mean number of lymphatic vessels counted in all cases ranged between 0 and 4.7. The median value of mean LMVD was 0.5, and defined the cut-off for low and high LMVD. RESULTS: We identified low intratumoral LMVD in 27 (47.4%) patients and high LMVD in 30 (52.6%) patients. High intratumoral LMVD was associated with lesser nodal involvement and fatal cases, lesser miometrial and adnaexal infiltration, and lesser cervical and peritoneal involvement. No association was seen between LMVD and age, FIGO staging histological type, vascular invasion, or lymph node involvement. CONCLUSION: Our results show association of high intratumoral LMVD with favorable prognosis in endometrial cancer