Institute of Pathology, Klinikum Augsburg, Augsburg, Germany.
Int J Colorectal Dis. 2012 Jun;27(6):721-6. doi: 10.1007/s00384-011-1373-7. Epub 2012 Jan 10.
The purpose of the present study is to characterise the lymphatic vessel density (LVD) in the T3 colorectal carcinoma and to correlate it with N status, grading and presence of tumour budding.
A total of 56 cases of T3 colorectal carcinoma were retrieved from the pathology's archive of Klinikum Augsburg. All slides were stained immunohistochemically with D2-40 (lymphatic endothelium) and with pancytokeratin to assess the tumour budding. Tumour budding and lymph vessel density were investigated independently by BM and CC. The highest density of lymphatic vessels was counted both in tumour centre (ILVD) and at the periphery of the tumour (PLVD) within an area of 0.24 mm(2).
Due to the strong intra-observer (BM and CC) difference in ILVD and PLVD, all cases were re-evaluated establishing a consensus that has been used for the further analyses. There was a significant difference between PLVD and ILVD (12 ± 4 versus 6 ± 3; P < 0.001). Moreover, we found a non-significant trend towards high PLVD in the cases with nodal metastasis versus the negative one, 13 ± 5/hpf versus 11 ± 4 (P = 0.072). There was no association between tumour budding and ILVD and PLVD (P = 0.249 and 0.38).
Colorectal carcinoma induces lymphangiogenesis. A higher PLVD could increase the capability of cancer cell to invade the lymphatic system. However, the obvious difficulties in immunohistochemical evaluation and the rather small differences between nodal positive and negative cases in T3 colorectal cancer seem to limit the clinical value of LVD evaluation.
本研究旨在描述 T3 结直肠癌中的淋巴管密度（LVD），并将其与 N 状态、分级和肿瘤芽生的存在相关联。
从 Klinikum Augsburg 的病理学档案中检索了 56 例 T3 结直肠癌病例。所有切片均用 D2-40（淋巴管内皮）和广谱细胞角蛋白进行免疫组织化学染色，以评估肿瘤芽生。肿瘤芽生和淋巴管密度由 BM 和 CC 独立进行评估。在 0.24mm² 的区域内，在肿瘤中心（ILVD）和肿瘤边缘（PLVD）分别计数最高密度的淋巴管。
由于 ILVD 和 PLVD 的观察者内差异较大（BM 和 CC），所有病例均重新评估，以达成共识，用于进一步分析。PLVD 与 ILVD 之间存在显著差异（12±4 比 6±3；P<0.001）。此外，我们发现淋巴结转移病例的 PLVD 有高于无淋巴结转移病例的趋势，分别为 13±5/hpf 和 11±4（P=0.072）。肿瘤芽生与 ILVD 和 PLVD 之间无相关性（P=0.249 和 0.38）。
结直肠癌诱导淋巴管生成。较高的 PLVD 可能增加癌细胞侵犯淋巴管系统的能力。然而，在 T3 结直肠癌中，免疫组织化学评估明显困难，且淋巴结阳性和阴性病例之间的差异相当小，这似乎限制了 LVD 评估的临床价值。
