Lymphatic microvessel density as prognostic marker in colorectal cancer
Lymphatic microvessel density as prognostic marker in colorectal cancer
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DOI：
10.1038/modpathol.3800651
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发表时间：
2006-10-01
期刊：
影响因子：
7.5
通讯作者：
Silverman, Jan F.
中科院分区：
文献类型：
--
作者：
Saad, Reda S.;Kordunsky, Lana;Silverman, Jan F.
淋巴结转移是疾病进展的重要预后指标，也是结直肠癌治疗策略的关键。在这项研究中，我们研究了肿瘤淋巴管生成和血管内皮生长因子（VEGF）表达作为预测淋巴结转移风险的标志物，以及它们与结直肠癌其他预后参数的关系。对90例结直肠癌患者进行了检查，其中30例无淋巴结转移，30例仅有淋巴结转移，30例有肝转移。免疫组化检测CD 31、D2-40和VEGF。在x 400视野（= 0.17 mm（2））下，对密集血管/淋巴灶（热点）中的阳性染色微血管进行计数。VEGF的染色强度在两级量表上评分。D2-40微淋巴管密度与CD 31计数（20 +/-9 vs 18 +/-6/0.17mm2，P < 0.05）和VEGF表达显著相关（P < 0.01）。VEGF在61/90例（67%）中表达。D2-40在48/90例患者中发现了淋巴肿瘤浸润，大于CD 31（37/90）和苏木素和伊红（H&E）（31/90）。D2-40、CD 31计数和VEGF表达与淋巴管浸润和淋巴结转移呈正相关（P < 0.05）。D2-40微淋巴管密度与肿瘤浸润深度、血管蒂阳性淋巴结和肝转移密切相关（P < 0.05）。结论：D2-40微淋巴管密度与淋巴管浸润、pT、淋巴结转移和肝转移呈正相关，具有预后意义。相对于H&E染色和内皮标志物CD 31，用D2-40的免疫染色增强了淋巴侵袭的检测。
Lymph node metastases is an important prognostic indicator for disease progression and crucial for therapeutic strategies in the work-up of colorectal carcinoma. In this study, we investigated tumor lymphangiogenesis and vascular endothelial growth factor (VEGF) expression as predictive markers for the risk of lymph node metastasis and their relation to other prognostic parameters in colorectal carcinoma. Resected colorectal carcinomas from 90 patients were examined, including 30 patients without lymph node metastases, 30 with only lymph node metastases, and 30 with liver metastases. Cases were immunostained for CD31, D2-40, and VEGF. Positivity stained microvessels were counted in densely vascular/lymphatic foci (hot spots) at x 400 field (=0.17mm(2)). Intensity of staining for VEGF was scored on a two-tiered scale. D2-40 lymphatic microvessel density demonstrated significant correlation with CD31 counts (20 +/- 9 vs 18 +/- 6/0.17mm(2) field, P < 0.05) and VEGF expression (P < 0.01). VEGF was expressed in 61/90 (67%) cases. D2-40 identified lymphatic tumor invasion in 48/90 patients, which was greater than CD31 (37/90) and hematoxylin and eosin (H&E) (31/90). There was a positive significant correlation of D2-40, CD31 counts, and VEGF expression with the presence of lymphovascular invasion and lymph node metastases (P < 0.05). D2-40 lymphatic microvessel density correlated significantly with depth of invasion (pT), positive vascular pedicle lymph nodes and liver metastases (P < 0.05). In conclusion, D2-40 lymphatic microvessel density showed prognostic significance with positive correlation with lymphovascular invasion, pT, and metastases to lymph nodes and liver. Immunostaining with D2-40 enhances the detection of lymphatic invasion relative to H&E staining and the endothelial marker, CD31.