Lin J Y, Li X Y, Dong P, Nakashima T
Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiaotong University, China.
J Laryngol Otol. 2011 Sep;125(9):945-51. doi: 10.1017/S0022215111001514. Epub 2011 Jul 21.
Metastasis to regional lymph nodes via lymphatic microvessels plays a key role in cancer progression, and is an important prognostic factor in many cancers. Recent evidence suggests that tumour lymphangiogenesis promotes lymphatic metastasis.
To investigate whether tumour lymphatic microvessel density correlates with clinicopathological factors and serves as a prognostic indicator of supraglottic laryngeal carcinoma progression.
The lymphatics of 84 supraglottic laryngeal carcinoma cases were investigated by immunohistochemical staining for podoplanin (also termed D2-40). The relationships between (intra- and peritumoural) lymphatic microvessel density, clinicopathological parameters and clinical prognosis were analysed.
There was a significant relationship between high intratumoural lymphatic microvessel density and aggressive tumour node stage (p < 0.0001), distant metastasis (p = 0.037) and poor prognosis (p = 0.011), and between high peritumoural lymphatic microvessel density and node stage (p = 0.004) and poor prognosis (p = 0.029). Patients with high lymphatic microvessel density also had significantly worse disease-free survival (p = 0.003) and overall survival (p = 0.005). Intratumoural lymphatic microvessel density was found to be an independent prognostic factor for overall survival (p = 0.008) and disease-free survival (p = 0.005) (multivariate analysis).
Lymphatic microvessel density (detected by podoplanin immunohistochemistry), especially intratumoural density, may be an independent predictor of lymphatic tumour spread and survival in supraglottic laryngeal carcinoma patients, and may be useful to guide decisions regarding additional surgery.
肿瘤细胞通过淋巴管微血管转移至区域淋巴结在癌症进展中起关键作用，并且是许多癌症的重要预后因素。最近的证据表明肿瘤淋巴管生成促进淋巴转移。
研究肿瘤淋巴管微血管密度是否与声门上型喉癌的临床病理因素相关，并作为其进展的预后指标。
采用抗足突蛋白（又称D2-40）免疫组化染色法研究84例声门上型喉癌病例的淋巴管情况。分析（肿瘤内和肿瘤周围的）淋巴管微血管密度、临床病理参数与临床预后之间的关系。
肿瘤内高淋巴管微血管密度与侵袭性肿瘤淋巴结分期（p<0.0001）、远处转移（p=0.037）及预后不良（p=0.011）显著相关，肿瘤周围高淋巴管微血管密度与淋巴结分期（p=0.004）及预后不良（p=0.029）显著相关。淋巴管微血管密度高的患者无病生存率（p=0.003）和总生存率（p=0.005）也显著较差。肿瘤内淋巴管微血管密度是总生存（p=0.008）和无病生存（p=0.005）的独立预后因素（多因素分析）。
淋巴管微血管密度（通过抗足突蛋白免疫组化检测），尤其是肿瘤内密度，可能是声门上型喉癌患者淋巴转移和生存的独立预测指标，可能有助于指导关于额外手术的决策。
