Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Medical Record, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
BMC Cancer. 2023 Apr 22;23(1):370. doi: 10.1186/s12885-023-10858-7.
Lymphovascular invasion (LVI) is a crucial predictor of lymph node metastasis (LNM). However, few studies have investigated the LVI positivity rate and its clinical significance in pT1b esophageal squamous cell carcinoma (ESCC) using immunohistochemistry and elastin staining.
We collected data from158 patients with pT1b ESCC who had undergone radical esophagectomy. All paraffin blocks of invasive carcinoma from each patient were subjected to HE staining, elastin staining + CK (AE1/AE3) immunohistochemistry (E&IHC), and CD31/D2-40 + CK (AE1/AE3) double immunohistochemistry (D-IHC). The LVI was classified into types, i.e., vascular invasion (VI) and lymphatic vessel invasion (LI), and its location, quantity, and clinical significance were explored.
The positivity rates of VI by E&IHC (E-VI), VI by CD31D-IHC (CD31-VI), and LI by D2-40 D-IHC (D2-40-LI) were significantly higher than those obtained by HE staining (P < 0.001, respectively). CD31-VI and E-VI were independent adverse prognostic factors for recurrence-free survival (RFS), and they were significantly associated with poor distant metastasis-free survival and overall survival in pT1b ESCC. Intratumoral LVI was also crucial in pT1b ESCC, and L2 (the count of D2-40-LI was 5 or more) was the strongest predictor for LNM and RFS in pT1b ESCC.
E&IHC and D-IHC can dramatically improve the detection rate of LVI in pT1b ESCC, and the classification and grading of LVI can help to improve the prediction of LNM and prognosis.
淋巴管浸润（LVI）是淋巴结转移（LNM）的重要预测因子。然而，使用免疫组织化学和弹力纤维染色，很少有研究调查 pT1b 食管鳞状细胞癌（ESCC）中的 LVI 阳性率及其临床意义。
我们收集了 158 例接受根治性食管切除术的 pT1b ESCC 患者的数据。每位患者的浸润性癌石蜡块均行 HE 染色、弹力纤维染色+CK（AE1/AE3）免疫组化（E&IHC）和 CD31/D2-40+CK（AE1/AE3）双重免疫组化（D-IHC）。LVI 分为血管浸润（VI）和淋巴管浸润（LI）两种类型，探讨其位置、数量及临床意义。
E&IHC（E-VI）、CD31 D-IHC（CD31-VI）和 D2-40 D-IHC（D2-40-LI）的 VI 阳性率均显著高于 HE 染色（P<0.001）。CD31-VI 和 E-VI 是无复发生存（RFS）的独立不良预后因素，与 pT1b ESCC 患者的远处无转移生存和总生存不良显著相关。肿瘤内 LVI 在 pT1b ESCC 中也很重要，L2（D2-40-LI 计数为 5 个或更多）是预测 pT1b ESCC 中 LNM 和 RFS 的最强预测因子。
E&IHC 和 D-IHC 可显著提高 pT1b ESCC 中 LVI 的检出率，LVI 的分类和分级有助于提高 LNM 和预后的预测。
