Pavlopoulos P M, Konstantinidou A E, Agapitos E, Kavantzas N, Nikolopoulou P, Davaris P
Department of Pathology, National University of Athens, Greece.
Cancer. 1998 Nov 15;83(10):2067-75.
Neovascularization reportedly is correlated with metastasis, recurrence, and prognosis in some types of tumors. Microvessel quantification in so-called "hot spots" has been studied extensively as the only factor reflecting angiogenesis in various malignant tumors. The objective of this report was to evaluate multiple morphometric microvascular characteristics in addition to microvessel density (MVD) in colorectal carcinomas to provide a better approach to examining the relation between angiogenesis and clinicopathologic factors and prognosis.
Histologic sections from 106 colorectal adenocarcinomas and 17 adenomas, immunostained for factor VIII, were evaluated by image analysis for the quantification of MVD, total vascular area (TVA), and microvascular branching, as well as several morphometric parameters related to the vessel size or shape.
MVD gradually decreased with progressing Dukes stage. The vascular branching counts were significantly higher in carcinomas than in adenomas, and remained unaffected through progressing Dukes stages. Shape-related parameters showed significant differences between carcinomas and adenomas and between different grades of differentiation. Branching counts and TVA were the only factors found to be of prognostic significance.
This study provides evidence that neovascularization is an early critical event in colorectal tumorigenesis, reaching a maximum level early in the malignant process. Its prognostic significance is better assessed by quantification of TVA and the branching pattern of microvessels, whereas MVD does not provide significant prognostic information for colorectal carcinoma patients.
据报道，新生血管形成与某些类型肿瘤的转移、复发及预后相关。在各种恶性肿瘤中，对所谓“热点”区域微血管进行定量分析已作为反映血管生成的唯一因素被广泛研究。本报告的目的是评估结直肠癌中除微血管密度（MVD）外的多种形态学微血管特征，以提供一种更好的方法来研究血管生成与临床病理因素及预后之间的关系。
对106例结直肠腺癌和17例腺瘤的组织切片进行VIII因子免疫染色，通过图像分析评估MVD、总血管面积（TVA）、微血管分支情况，以及与血管大小或形状相关的几个形态学参数。
MVD随Dukes分期进展逐渐降低。癌组织中的血管分支计数显著高于腺瘤，且在Dukes分期进展过程中保持不变。形状相关参数在癌组织与腺瘤之间以及不同分化程度之间存在显著差异。分支计数和TVA是仅有的具有预后意义的因素。
本研究提供的证据表明，新生血管形成是结直肠癌发生过程中的一个早期关键事件，在恶性进程早期达到最高水平。通过对TVA和微血管分支模式进行定量分析能更好地评估其预后意义，而MVD不能为结直肠癌患者提供显著的预后信息。
