Quantification of vascular density and of lumen and vessel morphology in endometrial carcinoma - Evaluation of their relation to serum levels of tissue polypeptide-specific antigen and CA-125

OBJECTIVE: To determine whether differences in tumor vessel architecture influence the entry of tumor-associated antigens into the circulation.STUDY DESIGN: Using an image analysis system, nine vascular parameters in samples of endometrial carcinomas stained for factor VIII-related antigen were evaluated. These were related to groups with, respectively, normal and elevated serum values for two different serum tumor markers: one with low tissue polypeptide-specific antigen (TPS) and one with high molecular weight (CA-125).RESULTS: Lumen area, lumen perimeter and maximum lumen diameter appeared to differentiate between the normal and elevated TPS group; the higher lumen values occurred in the latter (Nann and Whitney U test: P=.021, .013 and .014, respectively). For CA-125 It hi her number of vessels per square millimeter after correction for the epithelium-stroma ratio was found to differentiate between the normal and elevated group (P=.011). The other parameters did not show differentiation between the groups.CONCLUSION: Distension of vessels appears to be related to the TPS serum level; that might be explained by the presence of endothelial gaps, permitting passive passage of the small TPS molecules. Vascular density appears to be related to the CA-125 serum level. However, whether this relation is real remains to be determined.