Published online Jul 26, 2025. doi: 10.12998/wjcc.v13.i21.103841
Revised: March 19, 2025
Accepted: March 20, 2025
Published online: July 26, 2025
Processing time: 135 Days and 17.1 Hours
The microcystic, elongated, and fragmented (MELF) pattern of invasion in endometrioid endometrial carcinoma (EEC) is a special mode of myometrial invasion that has been recently recognized by the pathology community. Overexpression of CXC chemokine receptor 4 (CXCR4) in tumor cells contributes to tumor growth, invasion, angiogenesis, metastasis, and recurrence.
To explore the correlation between CXCR4 expression in EEC and MELF invasion and clinicopathological features.
A total of 205 EEC patients treated at Peking University People’s Hospital from June 2020 to December 2021 were selected (60 cases with MELF invasion, 145 cases without). The clinicopathological features of the two groups were compared, and expression of CXCR4 protein, estrogen receptor, and progesterone receptor was detected and compared by immunohistochemistry.
EEC with MELF invasion was significantly associated with low tumor grade, lymphovascular space invasion, deep myometrial invasion, cervical stromal involvement, and lymph node metastasis. There was a difference in CXCR4 expression between the two groups, with the MELF group having a significantly higher expression than the non-MELF group.
CXCR4 expression is significantly increased in EEC with MELF invasion and in the MELF invasion area, which may promote tumor invasion and metastasis and has some value for prognostic assessment.
Core Tip: Endometrioid endometrial carcinoma (EEC) with the microcystic, elongated, and fragmented (MELF) invasion is a special invasive pattern, and its risk of lymphovascular space invasion and lymph node metastasis is significantly higher than that of the non-MELF group. The presence of MELF infiltration in EEC is associated with a higher expression of CXC chemokine receptor 4, which may play a role in the progression of the disease.