Oh-e H, Tanaka S, Kitadai Y, Shimamoto F, Yoshihara M, Haruma K
First Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8551, Japan.
Dis Colon Rectum. 2001 Aug;44(8):1129-36. doi: 10.1007/BF02234633.
Intratumor microvessel count has been reported as a useful prognostic factor in patients with cancer of various organs. This study was undertaken to clarify the relation between microvessel count and lymph node metastasis in submucosal colorectal cancer.
Microvessel count was estimated in 254 invasive tumors that had been resected from patients with submucosal colorectal cancer. Immunohistochemistry with antibodies against CD34 was performed on archival specimens, and microvessel counts were estimated based on the average count of three fields (original magnification, x400) in the most vascular area at the site of deepest submucosal penetration.
Microvessel count ranged from 10 to 98, with a median of 40. Lesions with high microvessel counts (> or =40) had a significantly higher incidence of lymph node metastasis than those with low microvessel counts (<40; 21.8 percent vs. 6.2 percent). None of the 79 lesions with low microvessel counts and submucosal invasion up to a depth of 1,500 microm had metastasized to the lymph nodes. In multivariate analysis, microvessel count was an independent risk factor for lymph node metastasis in submucosal colorectal cancer (P = 0.0026).
Microvessel count at the site of deepest submucosal penetration can be one of the most useful predictors for lymph node metastasis. Analysis that combines microvessel count and depth of submucosal invasion may predict the occurrence of lesions without lymph node metastasis.
肿瘤内微血管计数已被报道为多种器官癌症患者有用的预后因素。本研究旨在阐明黏膜下结直肠癌微血管计数与淋巴结转移之间的关系。
对254例黏膜下结直肠癌患者切除的浸润性肿瘤进行微血管计数评估。对存档标本进行抗CD34抗体免疫组织化学检测，并根据黏膜下最深浸润部位血管最丰富区域三个视野（原始放大倍数，×400）的平均计数来评估微血管计数。
微血管计数范围为10至98，中位数为40。微血管计数高（≥40）的病变淋巴结转移发生率显著高于微血管计数低（<40）的病变（21.8%对6.2%）。79例微血管计数低且黏膜下浸润深度达1500微米的病变均未发生淋巴结转移。在多因素分析中，微血管计数是黏膜下结直肠癌淋巴结转移的独立危险因素（P = 0.0026）。
黏膜下最深浸润部位的微血管计数可能是淋巴结转移最有用的预测指标之一。结合微血管计数和黏膜下浸润深度的分析可能预测无淋巴结转移病变的发生。
