EPIDEMIOLOGY AND MORPHOLOGY INVESTIGATION OF CORPUS UTERI MA-LIGNANT TUMORS

The objective of the investigation is to study epidemiological and morphological features of the malignant tumors in the uterine body, and to determine the patterns of vascularization (microvascularization) of the intact, hyperplastic and neoplastic endometrium tissues. Methods. Epidemiological characteristics of the distribution of the malignant uterine tumors have been studied based on the reports in the cancer registry during the period of 2011 – 2017. A histological type and a tumor degree of the neoplastic tissue were determined on the sections of tumors, stained with hematoxylin and eosin. The vascularization patterns of the endometrial tissue were identified by the immune-histochemical analysis of the samples (CD31 and podoplanin receptors). The microvascular density in the studied samples was calculated by the amount of the CD31-positive patterns (single or cluster cell formations) in the previously obtained images of the tissue. The podoplanin-positive structures indicated the presence of the lymphatic vessels in the studied material. Results. The incidence rate of malignant tumors remains persistently high in Ukraine and in Sumy region (332.6±21.8 and 415±9.6 per 100,000 inhabitants). Among these incidents, the uterine neoplasia takes the third place with the rates 29.4±1.5 and 35.9±4.3 correspondingly. The disease peaks in people aged 55-69 (59%) and shows a general tendency throughout the country. The most common histological type of the malignant neoplasia in Sumy region is endometrioid adenocarcinoma with different degrees of differentiation (81.5%). The histological investigation revealed a variable distribution of vessels in the neoplastic tissue, both in the parenchimatous component and in the surrounding stroma of a tumor. These vessels are arteries, veins and single small vessels (arterioles and venules). The immune-histochemical investigation detected the increased capillary density (microvascularization) in the tumors of the endometrium. Herewith, a degree of the vessel density directly depended on a degree of the tumor cataplasia. Vascularization of the hyperplastic endometrial tissue exceeded the norm, and mainly arteries and veins represented it. It was found that the amount of the podoplanin-positive formations in the neoplastic tissue increased simultaneously with the growing amount of the lymphatic vessels in response to tumor progression (p<0.05). Conclusions. For the last 7 years, Ukraine and Sumy region have been facing high incidence rates of uterine cancer diseases, mortality, one- and five-years lethality with the peaks at the postmenopausal period. The most common histological type is endometrioid adenocarcinoma with the majority of poorly differentiated histological variants. The tumor transformation in the endometrium induces enhanced angiogenesis with the growing microvascular density. Lymphangiogenesis is activated relatedly. The density of the blood and lymphatic vessels directly depends on the differentiation of tumors and increases in response to cataplasia.