Yan Ge, Zhou Xiao-Yan, Cai San-Jun, Zhang Gui-Hong, Peng Jun-Jie, Du Xiang
Department of Pathology, Cancer Hospital of Fudan University, Shanghai 200032, China.
World J Gastroenterol. 2008 Jan 7;14(1):101-7. doi: 10.3748/wjg.14.101.
To investigate the distribution pattern of lymphatic vessels and microvessels in sporadic colorectal carcinoma (SCRC) and their relationship to metastasis and prognosis.
The lymphatic vessel density (LVD) and microvessel density (MVD) in tumor tissue obtained from 132 patients with primary SCRC, including 74 with metastases and 58 without metastases, were evaluated by immunohistochemistry using antibodies directed against D2-40 and von Willebrand factor (vWF).
(1) The lymphatic vessels and microvessels at central portions of SCRC often had a reticular architecture with numerous tiny and ill-defined lumina, while those at tumor borders had large and open lumina. The LVD and MVD were both obviously higher in colorectal cancer patients with metastases than in those without (P < 0.001). (2) For each one lymphatic vessel increased, there was a 1.45-fold increase in the risk of metastasis in SCRC. The specificity and sensitivity of LVD in predicting metastasis or non-metastasis in SCRC were 71.62% and 56.90%, respectively, and the corresponding LVD was 5. For each one microvessel increased, there was a 1.11-fold increase in the risk of metastasis in SCRC. The specificity and sensitivity of MVD were 66.22% and 51.72%, respectively. (3) Double labeling immunohistochemistry showed D2-40 immunoreactivity to be specific for lymphatic vessels. (4) Univariate analysis indicated that high LVD, high MVD, as well as co-accounting of high LVD and high MVD were associated with patient's poor disease-free survival (Puni < 0.05); multivariate analysis indicated that co-accounting of LVD and MVD was an independent prognostic factor of colorectal cancer.
D2-40 is a new specific antibody for lymphatic endothelial cells. Lymphogenesis and angiogenesis are commonly seen in SCRC, especially at tumor borders. The detection of LVD and MVD at tumor borders may be useful in predicting metastasis and prognosis in patients with SCRC, and, in particular, co-accounting of LVD and MVD might be a useful prognostic factor in SCRC.
研究散发性结直肠癌（SCRC）中淋巴管和微血管的分布模式及其与转移和预后的关系。
采用抗D2-40和血管性血友病因子（vWF）抗体，通过免疫组织化学法评估132例原发性SCRC患者肿瘤组织中的淋巴管密度（LVD）和微血管密度（MVD），其中74例有转移，58例无转移。
（1）SCRC中央部分的淋巴管和微血管通常呈网状结构，管腔众多且微小、界限不清，而肿瘤边缘的管腔大且开放。有转移的结直肠癌患者的LVD和MVD均明显高于无转移者（P<0.001）。（2）SCRC中每增加一条淋巴管，转移风险增加1.45倍。LVD预测SCRC转移或无转移的特异性和敏感性分别为71.62%和56.90%，对应的LVD为5。SCRC中每增加一条微血管，转移风险增加1.11倍。MVD的特异性和敏感性分别为66.22%和51.72%。（3）双重免疫组织化学标记显示D2-40免疫反应性对淋巴管具有特异性。（4）单因素分析表明，高LVD、高MVD以及高LVD和高MVD共同存在与患者无病生存期差相关（P单<0.05）；多因素分析表明，LVD和MVD共同存在是结直肠癌的独立预后因素。
D2-40是一种针对淋巴管内皮细胞的新型特异性抗体。淋巴管生成和血管生成在SCRC中常见，尤其是在肿瘤边缘。检测肿瘤边缘的LVD和MVD可能有助于预测SCRC患者的转移和预后，特别是LVD和MVD共同存在可能是SCRC的一个有用的预后因素。
