Prognostic significance of immunohistochemically detected blood and lymphatic vessel invasion in colorectal carcinoma: Its impact on prognosis
Prognostic significance of immunohistochemically detected blood and lymphatic vessel invasion in colorectal carcinoma: Its impact on prognosis
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DOI：
10.1245/s10434-006-9189-3
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发表时间：
2007-02-01
影响因子：
3.7
通讯作者：
Tabuchi, Takafumi
中科院分区：
文献类型：
--
作者：
Liang, Pin;Nakada, Ichiro;Tabuchi, Takafumi
背景：血管浸润（BVI）和淋巴管浸润（LVI）的预后意义尚不清楚。由于缺乏静脉和淋巴管的特异性标记物，早期的研究不能可靠地区分BVI和LVI。方法：通过podoplanin和CD 34抗原的免疫组织化学染色，我们回顾性研究了419例结直肠癌组织中的LVI和BVI。结果：苏木精-伊红（H&E）染色鉴别BVI和LVI的假阳性率为9.1%，假阴性率为12.6%。在有LVI的肿瘤中，BVI的发生率显著高于无LVI的肿瘤（P < .001）。在Logistic多因素分析中，只有LVI（P <0.001）与淋巴结转移相关，而BVI（P = 0.015）与远处复发相关。计算预后相关性，在单变量分析中，两种侵袭类型均与生存率降低相关（均P < .001）。在多变量分析中，BVI（P = 0.024），淋巴结状态（P = 0.003）和肿瘤分期（P <0.001）仍然具有统计学意义的因素survival.Conclusions：我们的研究结果表明，免疫组织学评价BVI和LVI可能是有用的结直肠癌淋巴结转移和复发的风险，从而有助于预后评估。
Background: The prognostic significance of blood vessel invasion (BVI) and lymphatic vessel invasion (LVI) is unclear. Because of the absence of specific markers for venous and lymphatic vessels, earlier studies could not reliably distinguish between BVI and LVI.Methods: By immunostaining for podoplanin and CD34 antigen, we retrospectively investigated LVI and BVI in 419 tissue specimens of colorectal carcinoma. We performed univariate and multivariate analysis of the clinicopathologic features, frequency of recurrence, and outcome of patients with or without LVI and BVI.Results: The use of hematoxylin and eosin (H&E) staining to identify BVI and LVI yielded a false positive rate of 9.1% and false negative rate of 12.6%. The incidence of BVI was significantly higher among tumors with LVI than tumors without LVI (P < .001). In logistic multivariate analysis, only LVI (P < .001) was associated with lymph node metastasis and BVI (P = .015) was associated with distant recurrence. Calculating the prognostic relevance, both two invasion types correlated with decreased survival in univariate analysis (both P < .001). In multivariate analysis, BVI (P = .024), lymph node status (P = .003) and tumor stage (P < .001) remained statistically significant factors for survival.Conclusions: Our results suggest that immunohistologic evaluation of BVI and LVI could be useful in colorectal carcinoma indicating the risk of lymph node metastasis and recurrence, thereby contributing to prognostic evaluation.