Novel pathological parameters in regional lymph nodes of urothelial carcinoma focused on "Seed and Soil" theory

研究1：51例接受肾输尿管切除术的患者。所有病例均有淋巴结，苏木精-伊红染色均为阴性。我们用抗细胞角蛋白免疫组织化学方法重新评估了LNS标本中微转移的存在。免疫组织化学显示51例患者中有7例(14%)出现微转移。研究2：我们前瞻性地评估了根治性膀胱切除术或肾输尿管切除术患者的淋巴结微转移的存在。在接受根治性膀胱切除术的患者中，9%(2/22)发现微转移。研究3：探讨VEGFC、VEGFD、VEGF3R基因在原发肿瘤中的表达及其与肿瘤病理特征的关系。随后，我们评估了区域淋巴结边缘区域的淋巴管密度(LVD)。PT2病组VEGFC mRNA的表达高于PT1病组。有转移者LVD高于无转移者。此外，半数无淋巴结转移的病例可见淋巴管聚集。

Study 1 : Fifty-one patients treated by nephroureterectomy were included. All had lymph nodes(LNs) and all LNs were negative on hematoxylin and eosin staining. We re-evaluated the presence of micrometastasis in LNs specimens by anti-cytokeratin immunohistochemistory. Immunohistochemistry identified micrometastases in 7(14%) of 51 patients. Study 2 : We prospectively evaluated the presence of micrometastasis in LNs in patients undergoing radical cystectomy or nephroureterectomy. Micrometastasis was detected in 9%(2/22) of patients undergoing radical cystectomy. Study 3 : We evaluated the association between the expression of VEGFC mRNA, VEGFD mRNA, or VEGF3R mRNA and pathological characteristic in primary tumors. We subsequently evaluated the lymph vascular density(LVD) in marginal zone of regional lymph nodes. The expression of VEGFC mRNA was higher in> pT2 disease than<pT1 disease. LVD was higher in patients with node metastasis than patients without it. In addition, the accumulation of lymphatic vessels was observed in half of the cases without node metastases.