Prall F, Gringmuth U, Nizze H, Barten M
Department of Pathology, University of Rostock, Germany.
Histopathology. 2003 May;42(5):482-91. doi: 10.1046/j.1365-2559.2003.01610.x.
Microvessel densities in cancers have been shown to be a prognostic factor for some types of cancer. For colorectal cancer, however, the situation is far from clear.
A consecutive series of 173 colorectal carcinomas was investigated, and to these were added 55 liver metastases originating from colorectal cancer. Microvessels were counted in hotspots (factor VIII immunostaining, 0.74 mm2). The capillary architecture was scored according to the degree of order and envelopment of the neoplastic glands. Endothelial proliferation was determined by factor VIII/Ki67 double labelling.
Mean microvessel densities were 51.8 for colorectal carcinomas (range 8-140) and 31.9 for liver metastases (range 3-101). Stratification according to stage, depth of infiltration and nodal involvement showed a significant inverse relation with increase. Mean microvessel densities in primaries were significantly higher than in metastases. Kaplan-Meier analysis showed a significantly higher cancer-specific survival for high microvessel densities (median as cut-off) and for a more ordered microvascular architecture. Endothelial proliferation in carcinomas was significantly higher than in normal mucosa.
Contrary to other types of cancer, for colorectal cancer high microvessel densities confer good rather than poor prognosis. We hypothesize that neoangiogenesis, though extant in colorectal cancer, is not rate-limiting in the metastatic cascade.
癌症中的微血管密度已被证明是某些类型癌症的预后因素。然而，对于结直肠癌，情况尚不清楚。
对连续的173例结直肠癌进行了研究，并加入了55例源自结直肠癌的肝转移瘤。在热点区域（因子VIII免疫染色，0.74平方毫米）计数微血管。根据肿瘤腺体的排列和包绕程度对毛细血管结构进行评分。通过因子VIII/Ki67双重标记确定内皮细胞增殖。
结直肠癌的平均微血管密度为51.8（范围8 - 140），肝转移瘤为31.9（范围3 - 101）。根据分期、浸润深度和淋巴结受累情况分层显示，随着这些因素增加，微血管密度呈显著负相关。原发肿瘤的平均微血管密度显著高于转移瘤。Kaplan-Meier分析显示，微血管密度高（以中位数为界）和微血管结构更规则的患者，癌症特异性生存率显著更高。癌组织中的内皮细胞增殖显著高于正常黏膜。
与其他类型癌症相反，对于结直肠癌，高微血管密度预示着良好而非不良的预后。我们推测，尽管结直肠癌中存在新生血管生成，但在转移级联反应中它并非限速因素。
