Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wroclaw, Poland
Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland.
Anticancer Res. 2014 Jun;34(6):3113-8.
Neolymphangiogenesis, a process of lymphatic vessel development in neoplastic tissue, may be a key event in the transmission of cancer cells into lymph nodes. The current study examined the relationship between lymphatic vessel density (LVD) measured by podoplanin (D2-40) expression, clinicopathological parameters and patient survival in gastric cancer.
D2-40 expression was examined by immunohistochemistry in formalin-fixed paraffin-embedded tissue specimens obtained from 60 patients with gastric cancer. D2-40 immunoreactivity was analyzed in intratumoral and peritumoral compartments of tumors and correlated with tumor grade, type in Lauren's classification, lymph node status, distant metastasis, presence of ulceration, inflammatory infiltration, angio-invasion, lymphangio-invasion and patient survival using a Receiver Operating Characteristic (ROC) curve analysis to find cut-off points that enabled fair decision making in survival analysis.
The mean values of intratumoral and peritumoral LVD were 6.63 and 11.25, respectively. Enhanced intratumoral LVD measured by D2-40 immunoexpression was correlated with the presence of lymph node metastases (p=0.04). Our study revealed a statistically significant correlation between intratumoral LVD measured by D2-40 expression and survival of patients with gastric cancer: an intratumoral LVD higher than 4.68 is significantly correlated with unfavorable prognosis, with a probability of death of approximately 80%. No significant relationship was identified between peritumoral LVD, lymph node status and survival in patients with gastric cancer.
A high intratumoral LVD measured by D2-40 expression in specimens from primary tumors is strongly associated with lymph node metastasis and predicts worse clinical outcome. Increased intratumoral D2-40 immunoreactivity is a putative predictor of aggressive gastric cancer behavior.
新淋巴管生成是肿瘤组织中淋巴管发育的过程，可能是癌细胞转移到淋巴结的关键事件。本研究探讨了在胃癌中，通过 podoplanin（D2-40）表达测量的淋巴管密度（LVD）与临床病理参数和患者生存之间的关系。
采用免疫组织化学方法检测 60 例胃癌患者福尔马林固定石蜡包埋组织标本中 D2-40 的表达。在肿瘤的瘤内和瘤周区域分析 D2-40 免疫反应性，并与肿瘤分级、Lauren 分类中的肿瘤类型、淋巴结状态、远处转移、溃疡形成、炎症浸润、血管侵犯、淋巴管侵犯以及患者生存相关，使用 ROC 曲线分析寻找能够在生存分析中进行公平决策的截止值。
肿瘤内和肿瘤旁 LVD 的平均值分别为 6.63 和 11.25。通过 D2-40 免疫表达测量的增强的肿瘤内 LVD 与淋巴结转移的存在相关（p=0.04）。我们的研究表明，通过 D2-40 表达测量的肿瘤内 LVD 与胃癌患者的生存之间存在统计学显著相关性：肿瘤内 LVD 高于 4.68 与不良预后显著相关，死亡概率约为 80%。肿瘤旁 LVD、淋巴结状态与胃癌患者的生存之间未发现显著相关性。
原发肿瘤标本中通过 D2-40 表达测量的高肿瘤内 LVD 与淋巴结转移密切相关，并预测临床结局较差。肿瘤内 D2-40 免疫反应性增加是侵袭性胃癌行为的潜在预测因子。
