Miyata Yasuyoshi, Kanda Shigeru, Ohba Kojiro, Nomata Koichiro, Eguchi Jiro, Hayashida Yasushi, Kanetake Hiroshi
Department of Urology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan.
J Urol. 2006 Jul;176(1):348-53. doi: 10.1016/S0022-5347(06)00520-9.
Lymph node metastasis is an important prognostic factor in many types of cancer. Recently several specific markers for lymphatic endothelium were developed that facilitate the quantification of lymphangiogenesis in human cancer tissues. We investigated the clinical and prognostic significance of lymphangiogenesis in patients with transitional cell carcinoma of the upper urinary tract.
We measured lymph vessel density and relative lymphatic vascular area in 125 specimens by quantitative immunohistochemical staining for D2-40 antibody (DakoCytomation, Glostrup, Denmark). These parameters were examined in the intratumor and peritumor areas, and measured using image analysis software.
Peritumor lymph vessel density and peritumor lymphatic vascular area correlated with lymph node metastasis and tumor grade. In the intratumor area lymphatic vessels were detected in only 16.0% of specimens. However, the presence of intratumor lymphatic vessels was associated with lymph node metastasis (p = 0.002). Multivariate analysis identified high peritumor lymphatic vascular area and the presence of intratumor lymphatic vessels as significant and independent factors of metastasis-free survival after surgery (OR = 5.11, p = 0.020 and OR = 2.92, p = 0.025, respectively). Multivariate analysis also identified the presence of intratumor lymphatic vessels as the only independent predictive factor of cause specific survival (OR = 3.89, p = 0.049).
Lymphangiogenesis may have important roles in tumor metastasis and survival in patients with transitional cell carcinoma of the upper urinary tract. Quantification of lymphatic vessels, especially peritumor lymphatic vascular area and intratumor lymphatic vessels, was useful for predicting metastasis-free survival. In addition, the presence of intratumor lymphatic vessels was an independent predictor of cause specific survival.
淋巴结转移是多种癌症的重要预后因素。最近开发了几种淋巴管内皮的特异性标志物，有助于对人类癌组织中的淋巴管生成进行定量分析。我们研究了上尿路移行细胞癌患者淋巴管生成的临床及预后意义。
我们通过对D2-40抗体（丹麦格罗斯特鲁普的达科西玛公司）进行定量免疫组化染色，测量了125个标本中的淋巴管密度和相对淋巴管面积。在肿瘤内和肿瘤周围区域检查这些参数，并使用图像分析软件进行测量。
肿瘤周围淋巴管密度和肿瘤周围淋巴管面积与淋巴结转移和肿瘤分级相关。在肿瘤内区域，仅16.0%的标本检测到淋巴管。然而，肿瘤内淋巴管的存在与淋巴结转移相关（p = 0.002）。多因素分析确定，高肿瘤周围淋巴管面积和肿瘤内淋巴管的存在是术后无转移生存的显著且独立因素（OR分别为5.11，p = 0.020和OR为2.92，p = 0.025）。多因素分析还确定肿瘤内淋巴管的存在是病因特异性生存的唯一独立预测因素（OR = 3.89，p = 0.049）。
淋巴管生成可能在上尿路移行细胞癌患者的肿瘤转移和生存中起重要作用。淋巴管定量分析，尤其是肿瘤周围淋巴管面积和肿瘤内淋巴管，有助于预测无转移生存。此外，肿瘤内淋巴管的存在是病因特异性生存的独立预测因素。
