Mannelqvist Monica, Stefansson Ingunn, Salvesen Helga B, Akslen Lars A
The Gade Institute, Section for Pathology, Haukeland University Hospital, Bergen, Norway.
Histopathology. 2009 Jan;54(2):174-83. doi: 10.1111/j.1365-2559.2008.03201.x.
Vascular invasion is a prognostic marker for many cancers, including endometrial carcinoma. Immunohistochemistry using D2-40 and CD31 antibodies makes it possible to differentiate between lymphatic vascular invasion (LVI) and blood vessel invasion (BVI). The aim was to examine lymphatic and blood vessel invasion separately and their associations with clinicopathological characteristics and prognosis.
Immunohistochemistry was performed on a retrospective population-based series of endometrial carcinoma. Altogether, 31% of the 276 tumours showed lymphatic involvement, whereas 18% showed blood vessel invasion. LVI and BVI were associated with histopathological variables such as histological grade and tumour growth pattern. Patients without vascular invasion had the best prognosis and those with BVI (with or without LVI) had the worst outcome, whereas patients with LVI had an intermediate survival on univariate analysis. Multivariate models indicated that both LVI and especially BVI had independent prognostic importance. Among endometrioid carcinomas, BVI was still significant.
Our findings support the biological importance of vascular spread through the haematogenic and lymphatic routes in endometrial cancer. The significant correlation found with clinical phenotype indicates that these markers may be relevant for patient management.
血管侵犯是包括子宫内膜癌在内的多种癌症的预后标志物。使用D2-40和CD31抗体进行免疫组织化学检测能够区分淋巴血管侵犯（LVI）和血管侵犯（BVI）。本研究旨在分别检测淋巴血管侵犯和血管侵犯情况，并探讨它们与临床病理特征及预后的关系。
对一系列基于人群的子宫内膜癌回顾性病例进行免疫组织化学检测。在276例肿瘤中，共有31%出现淋巴受累，18%出现血管侵犯。LVI和BVI与组织学分级和肿瘤生长方式等组织病理学变量相关。无血管侵犯的患者预后最佳，有BVI（无论有无LVI）的患者预后最差，而单因素分析显示有LVI的患者生存期处于中间水平。多因素模型表明，LVI尤其是BVI具有独立的预后意义。在子宫内膜样癌中，BVI仍具有显著意义。
我们的研究结果支持子宫内膜癌中通过血行和淋巴途径进行血管播散的生物学重要性。与临床表型的显著相关性表明这些标志物可能对患者管理具有重要意义。
