Macrophage Density Patterns in Uterine Leiomyomas Across Patient Age Groups: Evaluation of Separately Quantified CD68-Positive and CD163-Positive Cells

Tumor-associated macrophages (TAMs), key effectors of the innate immune system, actively participate in extracellular matrix remodeling, angiogenesis, and tumor growth. However, their age-associated quantitative and phenotypic distribution in uterine leiomyoma microenvironment remains insufficiently understood. This study aims to evaluate the density and spatial distribution of CD68+ and CD163+ macrophage immunophenotypes in uterine leiomyoma stroma across distinct patient age groups.

Methods

A total of 318 patients with histologically confirmed uterine leiomyoma were stratified into three chronological age cohorts: Group I (≤30 years, n = 42), Group II (31–45 years, n = 216), and Group III (≥46 years, n = 60). Archival paraffin-embedded tumor tissue sections were analyzed histologically with hematoxylin and eosin, and immunohistochemically using antibodies against CD68 and CD163. Digital morphometric analysis was performed using QuPath software on whole-slide images, evaluating median immunopositive cell densities (cells/mm2) across five standardized regions of interest per case.