Loeb Stacy, Roehl Kimberly A, Yu Xiaoying, Antenor Jo Ann V, Han Misop, Gashti Sara N, Yang Ximing J, Catalona William J
Department of Urology, Georgetown University School of Medicine, Washington, DC, USA.
Urology. 2006 Jul;68(1):99-103. doi: 10.1016/j.urology.2006.02.004. Epub 2006 Jun 27.
Patients and referring physicians often ask about the significance of lymphovascular invasion (LVI) on pathology reports from radical prostatectomy specimens. However, limited data are available concerning the relationship between LVI and preoperative screening characteristics, pathologic tumor features, and patient prognosis.
LVI was evaluated for its ability to predict elevated prostate-specific antigen velocity, adverse pathologic features, and biochemical progression in 1709 men who underwent radical prostatectomy for clinically localized disease.
LVI was present in 118 (7%) of the 1709 men. On univariate analysis, LVI was significantly associated with tumor grade, tumor volume, and other adverse pathologic features. Prostate-specific antigen velocity was not significantly associated with the presence of LVI. Biochemical progression occurred in 34% of those with LVI compared with 10% of those without LVI (P <0.0001). However, on multivariate analysis with other pathologic tumor features, LVI was not an independent predictor of progression.
LVI is a relatively uncommon finding in radical prostatectomy specimens for clinically localized disease. Although LVI was seen primarily in large-volume, high-grade tumors, it was not an independent predictor of progression in the multivariate model.
患者及转诊医生常常询问根治性前列腺切除标本病理报告中淋巴管侵犯（LVI）的意义。然而，关于LVI与术前筛查特征、病理肿瘤特征及患者预后之间关系的数据有限。
对1709例因临床局限性疾病接受根治性前列腺切除术的男性患者，评估LVI预测前列腺特异性抗原速度升高、不良病理特征及生化进展的能力。
1709例男性患者中有118例（7%）存在LVI。单因素分析显示，LVI与肿瘤分级、肿瘤体积及其他不良病理特征显著相关。前列腺特异性抗原速度与LVI的存在无显著相关性。LVI患者中34%发生生化进展，而无LVI患者中这一比例为10%（P<0.0001）。然而，在与其他病理肿瘤特征进行多因素分析时，LVI并非进展的独立预测因素。
在临床局限性疾病的根治性前列腺切除标本中，LVI是相对不常见的发现。尽管LVI主要见于大体积、高级别肿瘤，但在多因素模型中它并非进展的独立预测因素。
