Lymphatic and/or blood vessel invasion in gastric cancer:: relationship with clinicopathological parameters, biological factors and prognostic significance
Lymphatic and/or blood vessel invasion in gastric cancer:: relationship with clinicopathological parameters, biological factors and prognostic significance
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DOI：
10.1007/s00432-007-0264-3
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发表时间：
2008-02-01
影响因子：
3.6
通讯作者：
Vizoso, Francisco J.
中科院分区：
文献类型：
--
作者：
del Casar, Jose M.;Corte, Maria D.;Vizoso, Francisco J.
背景淋巴和/或血管肿瘤侵袭（LBVI）是胃癌常见的组织病理学发现，这可能使其成为一种额外的成本效益指标，并有助于检测患者的复发风险。材料与方法本研究以144例连续行手术治疗的原发性胃腺癌患者为研究对象。采用H&E染色和抗cd34免疫组化染色对LBVI进行评价。用放射配体技术分析瘤内EGFR水平，用ELISA法测定c-erbB-2和tPA水平；免疫放射测定pS2、组织蛋白酶D和透明质酸；免疫组化检测VEGFR-1和vegfr -2。平均随访时间为33.1个月。结果LBVI 46例（31.9%）。LBVI的存在与肿瘤分期、淋巴结受累程度、手术可切除性、组织学类型和组织学分级均有显著相关性，在II-IV期肿瘤（P = 0.0001）、低分化（P = 0.01）、弥漫型（P = 0.009）、R1-R2 （P = 0.002）和淋巴结阳性（P = 0.005）肿瘤中存在的比例较高。此外，统计分析表明，在单因素分析（P = 0.0001）和多因素分析（P = 0.009）中，LBVI与较差的患者总生存率显著相关。然而，我们的结果未能显示LBVI与所研究的任何肿瘤内生物学参数之间的任何显著关系。结论LBVI为鉴别胃癌复发风险患者提供了额外的有用信息，这些患者可能是进一步辅助治疗的候选者。
Background Lymphatic and/or blood vessel tumoral invasion (LBVI) is a common histopathologic finding of gastric carcinomas, which could make it an additional cost efficient marker and help in the detection of patients at risk for recurrence.Materials and methods The subjects of this study were 144 patients with primary gastric adenocarcinoma, who consecutively underwent surgery. LBVI was evaluated by H&E staining and complementary with immunohistochemical staining with anti-CD34. Intratumoral levels of EGFR were analyzed with a radioligand technique, whereas c-erbB-2 and tPA were determined by ELISA methods; pS2, cathepsin D and hyaluronic acid by immunoradiometric assays; and VEGFR-1 and -2 by immunohistochemical assays. The mean follow-up period for these patients was 33.1 months.Results LBVI was present in 46 patients (31.9%). The presence of LBVI correlated significantly with tumor stage, lymph node involvement, surgical resectability, histological type and histological grade, being present in a higher percentage among II-IV tumor stage (P = 0.0001), poorly differentiated (P = 0.01), diffuse type (P = 0.009), R1-R2 (P = 0.002) and lymph node-positive (P = 0.005) tumors. In addition, statistical analysis demonstrated that LBVI was significantly associated with a poorer overall patients' survival in the univariate analysis (P = 0.0001) as well as in the multivariate analysis (P = 0.009). However, our results failed to show any significant relationship between LBVI and any of the intratumoral biological parameters studied.Conclusion LBVI provides additional useful information that could be applied to identify gastric cancer patients at risk for recurrence, who might be candidates for further adjuvant therapies.