Lymphatic Vessel Density and VEGF-C Expression are Significantly Different Among Benign and Malignant Thyroid Lesions
Lymphatic Vessel Density and VEGF-C Expression are Significantly Different Among Benign and Malignant Thyroid Lesions
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DOI：
10.1007/s12022-010-9116-9
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发表时间：
2010-06-01
影响因子：
4.4
通讯作者：
Camargo, Roberto Souza
中科院分区：
文献类型：
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作者：
Garcia, Eduardo Anselmo;Simoes, Kleber;Camargo, Roberto Souza
甲状腺癌是全世界最常见的内分泌肿瘤。转移和局部区域侵袭的途径优先通过淋巴管发生。因此，淋巴管密度（LVD）的评估应该代表预后参数和潜在的治疗目标。为了评估 LVD 在良性和恶性甲状腺病变中的价值，我们使用 D2-40（淋巴管特异性标记物）和血管内皮生长因子 C (VEGF-C)（淋巴增殖最有效的分子）分析了 110 例甲状腺切除标本。乳头状癌和滤泡状癌的 LVD 总数 (p = 0.045) 和瘤周面积 (p = 0.042) 之间存在显着差异。滤泡性腺瘤和滤泡性癌在瘤内 (p = 0.019) 和瘤周 (p = 0.033) LVD 方面存在重要差异。 VEGF-C 在恶性肿瘤中比在良性病变中表达更显着 (p = 0.0001)。与良性病变相比，几乎所有 VEGF-C 高阳性表达的癌症也表现出瘤周 LVD 增加 (p = 0.049)。事实上，恶性甲状腺病变的高瘤周 LVD 对于手术计划来说是一个重要的发现，并支持在恶性甲状腺肿瘤中进行甲状腺全切除术，因为瘤周淋巴管绝对是肿瘤细胞的逃逸路径。
Thyroid cancer is the most frequent endocrine neoplasia worldwide. The route for metastasis and loco-regional invasion preferentially occurs by lymphatic vessels. For this reason, the assessment of lymphatic vessel density (LVD) is supposed to represent both a prognostic parameter and also a potential therapeutic target. In order to evaluate the value of LVD in benign and malignant thyroid lesions, we analyzed 110 thyroidectomy specimens using D2-40, a specific marker for lymphatic vessels and vascular endothelial growth factor C (VEGF-C), the most potent molecule of lymphatic proliferation. LVD was significantly different between papillary and follicular carcinomas in total (p = 0.045) and peritumoral area (p = 0.042). Follicular adenoma and follicular carcinoma showed an important difference of intra- (p = 0.019) and peritumoral (p = 0.033) LVD. VEGF-C was more markedly expressed in malignancies than in benignant lesions (p = 0.0001). Almost all cancers with high positive VEGF-C expression also exhibited increased peritumoral LVD (p = 0.049) when compared with the benignant lesions. Indeed, the high peritumoral LVD of malignant thyroid lesions is an important finding for surgery planning and supports the practice of total thyroidectomy in malignant thyroid neoplasm's since the lymphatic peritumoral vessels definitely are an escape path for tumor cells.