Arora Aditi, Bansal Ankur
Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
, Lucknow, India.
Int Urol Nephrol. 2017 Jun;49(6):1007-1014. doi: 10.1007/s11255-017-1565-3. Epub 2017 Mar 13.
To evaluate the role of microvessel density (MVD) in predicting lymph node (LN) metastasis in penile squamous cell carcinoma (PSCC).
Records of 266 patients with PSCC were analyzed. Parameters examined were tumor stage, grade, nodal status, intratumoral and peritumoral MVD. Univariate and multivariate analyses were used to evaluate association between different histopathological variables and MVD. ROC was plotted to derive a prediction model using appropriate cutoff values of the parameters predicting cancer progression.
77 patients were found to have histologically proven metastatic LN. MVD did not correlate significantly with T stage and grade of tumor. The intratumoral and peritumoral MVD of patients with metastatic LN was significantly higher than patients with negative LN (58.92 vs. 49.89 and 65.57 vs. 53.72, respectively; P < 0.0001). Multivariate analysis also revealed that MVD (intratumoral and peritumoral) was independent predictor for LN metastasis. From ROC curve, at the cutoff value of 54, intratumoral MVD predicted LN metastasis with sensitivity of 91% and specificity of 87%. Similarly, at cutoff value of 61, peritumoral MVD predicted LN metastasis with sensitivity of 94% and specificity of 89%. The 5-year survival was 79 and 77% for those with low intratumoral and peritumoral MVD, respectively, as compared to 41 and 39% for those with high intratumoral and peritumoral MVD, respectively (P < 0.05).
Higher intratumoral and peritumoral MVD predicts cancer progression in patients with PSCC. Patients with an intratumoral MVD of 54 and peritumoral MVD of 61 have lymph node metastasis with a high sensitivity and specificity. The overall 5-year survival of patients is poor in high intratumoral or peritumoral MVD.
评估微血管密度（MVD）在预测阴茎鳞状细胞癌（PSCC）淋巴结（LN）转移中的作用。
分析266例PSCC患者的记录。检查的参数包括肿瘤分期、分级、淋巴结状态、肿瘤内和肿瘤周围的MVD。采用单因素和多因素分析来评估不同组织病理学变量与MVD之间的关联。绘制ROC曲线以使用预测癌症进展的参数的适当临界值得出预测模型。
77例患者经组织学证实有转移性LN。MVD与肿瘤的T分期和分级无显著相关性。有转移性LN患者的肿瘤内和肿瘤周围MVD显著高于无LN转移患者（分别为58.92对49.89和65.57对53.72；P < 0.0001）。多因素分析还显示，MVD（肿瘤内和肿瘤周围）是LN转移的独立预测因素。根据ROC曲线，在临界值为54时，肿瘤内MVD预测LN转移的敏感性为91%，特异性为87%。同样，在临界值为61时，肿瘤周围MVD预测LN转移的敏感性为94%，特异性为89%。肿瘤内和肿瘤周围MVD低的患者5年生存率分别为79%和77%，而肿瘤内和肿瘤周围MVD高的患者分别为41%和39%（P < 0.05）。
较高的肿瘤内和肿瘤周围MVD可预测PSCC患者的癌症进展。肿瘤内MVD为54且肿瘤周围MVD为61的患者发生淋巴结转移的敏感性和特异性较高。肿瘤内或肿瘤周围MVD高的患者总体5年生存率较差。
