Korkolopoulou P, Konstantinidou A E, Kavantzas N, Patsouris E, Pavlopoulos P M, Christodoulou P, Thomas-Tsagli E, Davaris P
Department of Pathology, National University of Athens, Greece.
Virchows Arch. 2001 Jun;438(6):603-11. doi: 10.1007/s004280100400.
Recent research has shown that neovascularization, quantitated by microvessel density (MVD), constitutes a strong prognostic indicator in patients with invasive urothelial carcinomas. These studies, however, have focused only on MVD as the only factor reflecting angiogenesis in transitional-cell carcinomas (TCCs). The objective of this report was to evaluate multiple morphometric microvascular characteristics besides MVD in superficial and muscle-invasive TCCs separately, to provide a better approach to the relationship between angiogenesis, clinicopathological parameters, and prognosis. Histologic sections from 115 TCCs [35 superficial (T1) and 80 muscle-invasive] were immunostained for CD31 and evaluated using image analysis for the quantitation of MVD, area, total vascular area, major axis length, minor axis length, perimeter, compactness, shape factor, and Feret diameter. Patients were followed-up until death (n=31) or for an average of 42.2 months (median 38.5 months). MVD increased with progressing T category (P=0.049) but area (P=0.033), major axis length (P=0.022), perimeter (P=0.043), and Feret diameter (P=0.042) were highest in T2 tumors. Area was the single independent predictor of adverse significance in T1 TCCs, whereas for muscle-invasive tumors, survival was independently predicted by MVD. Regarding disease-free survival in superficial tumors, the single significant independent parameter was compactness, whereas area was an independent favorable indicator of disease-free survival for patients with invasive TCCs. It is concluded that the prognostic significance of neovascularization is better assessed by area and shape-related morphometric characteristics, whereas MVD becomes influential only with regard to overall survival of patients with invasive tumors.
近期研究表明，通过微血管密度（MVD）定量的新生血管形成是浸润性尿路上皮癌患者的一个强有力的预后指标。然而，这些研究仅将MVD作为反映移行细胞癌（TCC）血管生成的唯一因素。本报告的目的是分别评估浅表性和肌层浸润性TCC中除MVD之外的多个形态学微血管特征，以更好地探讨血管生成、临床病理参数与预后之间的关系。对115例TCC[35例浅表性（T1）和80例肌层浸润性]的组织切片进行CD31免疫染色，并使用图像分析评估MVD、面积、总血管面积、长轴长度、短轴长度、周长、紧密度、形状因子和费雷特直径。对患者进行随访直至死亡（n = 31）或平均随访42.2个月（中位数38.5个月）。MVD随T分期进展而增加（P = 0.049），但面积（P = 0.033）、长轴长度（P = 0.022）、周长（P = 0.043）和费雷特直径（P = 0.042）在T2肿瘤中最高。面积是T1期TCC不良预后的唯一独立预测因素，而对于肌层浸润性肿瘤，生存由MVD独立预测。关于浅表性肿瘤的无病生存期，唯一显著的独立参数是紧密度，而面积是浸润性TCC患者无病生存期的独立有利指标。结论是，通过面积和形状相关的形态学特征可以更好地评估新生血管形成的预后意义，而MVD仅对浸润性肿瘤患者的总生存有影响。
