Analysis of Tumor-Associated Macrophages (TAM) Using Cluster of Differentiation 68 (CD68) Immunohistochemical Marker in Endometrial Carcinoma

Introduction Endometrial carcinoma is a common gynaecological malignancy in which tumor progression is influenced not only by neoplastic cells but also by the tumor microenvironment. Tumor-associated macrophages (TAMs) play a key role in modulating tumor behavior and provide prognostic insights depending on their distribution pattern. Objectives To evaluate Tumor-associated macrophages (TAMs) using CD68 immunohistochemistry marker and analyze their spatial distribution in endometrial carcinoma, and to correlate the localization of TAM with tumor grade, stage, myometrial invasion, and lymph node metastasis. Materials and methods This retrospective pilot study was conducted in the Department of Pathology at Sri Ramachandra Medical College and Research Institute from January 2024 to December 2024, using seven formalin-fixed paraffin-embedded tissue samples of histopathologically confirmed endometrial carcinoma. Tissue sections were stained with the CD68 antibody, which highlights TAMs. Their distribution was assessed as stromal, intratumorally, and along the invasive margin. Clinicopathological data were retrieved from lab reports, and the findings were analyzed using Statistical Package for Social Sciences (SPSS), version 16 (SPSS Inc., Chicago, IL) Results The mean age of study participants was 63.0 ± 7.28 years, with endometrioid carcinoma being the most common subtype, five cases (71.4%). CD68-positive TAMs showed a heterogeneous distribution, located in the stroma in four cases (57.1%), intratumorally in two cases (28.6%), and at the invasive margin in one case (14.3%). There was no statistically significant association observed between TAM localization and tumor grade (p=1.00) or stage (p=1.00). Conclusion TAMs in endometrial carcinoma demonstrate spatial heterogeneity with stromal predominance, suggesting a role in tumor microenvironment modulation. However, CD68-based assessment alone showed no significant association with clinicopathological parameters in our study. Hence, further studies with a larger sample size and additional markers are recommended.