Radi Dina A, Abd-Elazeem Marwa A
Tanta University, Tanta, Egypt.
Tanta University, Tanta, Egypt
Int J Surg Pathol. 2016 May;24(3):219-26. doi: 10.1177/1066896915611488. Epub 2015 Oct 12.
Background Lymphovascular invasion is an important pathway of metastatic spread and regional lymph node metastasis is the major prognostic factor in prostatic adenocarcinoma. D2-40 is used to identify the lymphatic vessels and to assess the lymphatic vessel density (LVD). Expression of claudin-4 may be related to invasion and progression of carcinoma cells in several primary tumors. Aim To evaluate intra- and peritumoral LVD through immunohistochemical expression of D2-40 in relation to claudin-4 expression and clinicopathological parameters in prostatic adenocarcinoma. Materials and Methods Immunohistochemical staining procedure was performed on 53 paraffin-embedded blocks of radical prostatectomy specimens for prostatic adenocarcinoma using anti D2-40 and claudin-4 antibodies. Sections were evaluated for mean LVD in intratumoral and peritumoral tissues assessed by D2-40 expression. Results LVD in intratumoral tissues was significantly lower compared with peritumoral areas (P = .0001). Peritumoral mean LVD was significantly higher in cases with lymphovascular invasion (P = .041) and in cases with positive lymph node metastasis (P = .003) than intratumoral mean LVD. High claudin-4 expression was significantly correlated with high tumor grade (P = .0001), lymphovascular invasion (P = .006), and positive lymph node metastasis (P = .004). High claudin-4 expression was significantly associated with increased mean LVD in peritumoral tissues. Conclusion Increased peritumoral mean LVD in prostatic adenocarcinoma is associated with lymphovascular invasion and positive lymph node metastasis. High claudin-4 expression is associated with high tumor grade, lymphocascular invasion, positive lymph node metastasis, and high mean peritumoral LVD suggesting that D2-40 and claudin-4 may represent different mechanisms of lymphatic vessel invasion with both biomarkers is related to poor prognosis.
背景 淋巴管浸润是转移扩散的重要途径，区域淋巴结转移是前列腺腺癌的主要预后因素。D2-40用于识别淋巴管并评估淋巴管密度（LVD）。紧密连接蛋白4的表达可能与几种原发性肿瘤中癌细胞的侵袭和进展有关。目的 通过D2-40的免疫组化表达评估前列腺癌瘤内和瘤周的LVD，并与紧密连接蛋白4的表达及临床病理参数相关联。材料与方法 对53例前列腺癌根治性切除标本的石蜡包埋块，使用抗D2-40和紧密连接蛋白4抗体进行免疫组化染色。通过D2-40表达评估瘤内和瘤周组织的平均LVD。结果 瘤内组织的LVD显著低于瘤周区域（P = 0.0001）。淋巴管浸润病例（P = 0.041）和淋巴结转移阳性病例（P = 0.003）的瘤周平均LVD显著高于瘤内平均LVD。紧密连接蛋白4高表达与高肿瘤分级（P = 0.0001）、淋巴管浸润（P = 0.）、淋巴结转移阳性（P = 0.004）显著相关。紧密连接蛋白4高表达与瘤周组织中平均LVD增加显著相关。结论 前列腺癌瘤周平均LVD增加与淋巴管浸润和淋巴结转移阳性相关。紧密连接蛋白4高表达与高肿瘤分级、淋巴管浸润、淋巴结转移阳性及瘤周平均LVD高相关，提示D2-40和紧密连接蛋白4可能代表淋巴管浸润的不同机制，这两种生物标志物均与预后不良相关。
