Original Articles
Angiogenesis in early-invasive and low-malignant-potential epithelial ovarian carcinoma

https://doi.org/10.1016/S0029-7844(99)00608-0Get rights and content

Abstract

Objective: To evaluate angiogenesis in ovaries of women with stage I invasive and low-malignant-potential epithelial ovarian carcinoma.

Methods: Ovarian specimens of 49 consecutive women with primary stage I invasive (n = 15) or stage I low-malignant-potential epithelial ovarian carcinoma (n = 34) were stained immunohistochemically for factor VIII–related antigen. Microvessel counts were tested for correlation with patient age, race, parity, previous oral contraceptive use, histologic type, tumor grade, tumor size, ascites, tumor excrescences, and disease-free and overall survival. Statistical analysis included multiple linear regression, Student t tests, factorial analysis of variance, and Cox proportional hazards regression, with P < .05 considered statistically significant.

Results: Microvessel counts of ovarian specimens of women with stage I invasive epithelial ovarian carcinoma (median 30, range 17–73) were significantly higher than those of women with stage I low-malignant-potential epithelial ovarian carcinoma (median 10, range 5–23), (P < .001). Among women with low-malignant-potential disease, microvessel counts did not differ significantly between serous and mucinous carcinomas (median 10, range 5–23 versus median 11, range 5–20, respectively, P = .78). There was no correlation between microvessel counts and age, tumor grade, tumor size, ascites, or tumor excrescences.

Conclusion: Angiogenesis as assessed by microvessel counts is more intense in stage I invasive ovarian epithelial carcinoma compared with stage I low-malignant-potential carcinoma, and might assist in differentiating between these histopathologic entities.

Section snippets

Methods

Angiogenesis was studied in ovaries of consecutive women who had surgical staging for stage I invasive and low-malignant-potential epithelial ovarian carcinoma between January 1, 1984, and July 1, 1998, at the State University Hospital Health Science Center at Brooklyn, and Kings County Medical Center, Brooklyn, New York. Stage was determined according to International Federation of Gynecology and Obstetrics (FIGO).17 Women diagnosed with epithelial ovarian carcinoma had extended FIGO surgical

Results

Ovarian specimens of 49 consecutive women were stained immunohistochemically for factor VIII–related antigen. The antifactor VIII–related antigen stained the vascular endothelial cells brown, as in typical fields from cases of stage I invasive (Figure 1) and low-malignant-potential epithelial ovarian carcinoma (Figure 2). Microvessel counts according to substage of disease, tumor histopathology, and tumor grade are presented in Table 1. Microvessel counts of women with invasive carcinoma

Discussion

We found that invasive ovarian epithelial carcinoma is associated with statistically significant increased angiogenesis compared with low-malignant-potential disease. In low-malignant-potential tumors, microvessel counts in stroma underlying normal epithelium were statistically significantly lower than those underlying the low-malignant-potential epithelium, which indicates that the angiogenic switch occurs between benign ovarian epithelium and low-malignant-potential disease. Therefore,

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