Assessment of vascular invasion in gastric cancer: A comparative study
Assessment of vascular invasion in gastric cancer: A comparative study
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DOI：
10.3748/wjg.v19.i24.3761
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发表时间：
2013-06-28
影响因子：
4.3
通讯作者：
Demas Alvares Cabral, Monica Maria
中科院分区：
文献类型：
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作者：
Gresta, Leticia Trivellato;Rodrigues-Junior, Ismael Alves;Demas Alvares Cabral, Monica Maria
目的：比较苏木精-伊红（HE）和免疫组化（IHC）检测胃癌组织中淋巴管和血管浸润（LVI和BVI）的价值，并与淋巴结状态进行相关性分析。（方法）-E-M：采用D2-40（一种淋巴管内皮标记物）和CD 34（一种泛内皮标记物）进行IHC，以研究95例原发性胃癌病例的连续手术标本中的LVI和BVI。采用McNemar检验和kappa指数将IHC研究结果与HE检测结果进行比较。肿瘤的形态学特征、LVI和BVI的存在与淋巴结转移有关。结果：胃癌患者中LVI的检出率明显高于BVI，且LVI与BVI之间的相关性不显著。IHC研究确定了LVI的8例假阳性病例和13例假阴性病例，以及BVI的24例假阳性病例和10例假阴性病例。LVI（k = 0.50）和BVI（k = 0.20）的平均Kappa值分别为中等和较低。LVI和BVI均与淋巴结转移存在统计学相关（HE：P = 0.001，P = 0.013; IHC：P = 0.001，P = 0.019）。与LVI相关的形态学特征为肿瘤位于胃远端1/3（P = 0.039）、Borrmann大体类型（P = 0.001）、器官浸润（P = 0.03）和肿瘤浸润深度（P = 0.001）。BVI的存在仅与肿瘤浸润深度有关（P = 0.003）。结论：免疫组化法检测淋巴管和血管有助于提高肿瘤血管浸润诊断的准确性，并有助于预测淋巴结转移。(C)2013年百世登。All rights reserved.
AIM: To evaluate and compare detection of lymphatic and blood vessel invasion (LVI and BVI) by hematoxylin-eosin (HE) and immunohistochemistry (IHC) in gastric cancer specimens, and to correlate with lymph node status.(ETHODS)-E-M: IHC using D2-40 (a lymphatic endothelial marker) and CD34 (a pan-endothelial marker) was performed to study LVI and BVI in surgical specimens from a consecutive series of 95 primary gastric cancer cases. The results of the IHC study were compared with the detection by HE using McNemar test and kappa index. The morphologic features of the tumors and the presence of LVI and BVI were related to the presence of lymph node metastasis. A chi(2) test was performed to obtain associations between LVI and BVI and other prognostic factors for gastric cancer.RESULTS: The detection rate of LVI was considerably higher than that of BVI. The IHC study identified eight false-positive cases and 13 false-negative cases for LVI, and 24 false-positive cases and 10 false-negative cases for BVI. The average Kappa value determined was moderate for LVI (k = 0.50) and low for BVI (k = 0.20). Both LVI and BVI were statistically associated with the presence of lymph node metastasis (HE: P = 0.001, P = 0.013, and IHC: P = 0.001, P = 0.019). The morphologic features associated with LVI were location of the tumor in the distal third of the stomach (P = 0.039), Borrmann's macroscopic type (P = 0.001), organ invasion (P = 0.03) and the depth of tumor invasion (P = 0.001). The presence of BVI was related only to the depth of tumor invasion (P = 0.003).CONCLUSION: The immunohistochemical identification of lymphatic and blood vessels is useful for increasing the accuracy of the diagnosis of vessel invasion and for predicting lymph node metastasis. (C) 2013 Baishideng. All rights reserved.