Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2010

01-01-2010 | Gastrointestinal Oncology

Increased Intratumoral Lymphatic Vessel Density Correlates with Lymph Node Metastasis in Early Gastric Carcinoma

Authors: Kyoungbun Lee, MD, Do Joong Park, MD, Gheeyoung Choe, MD, Hyung Ho Kim, MD, Woo Ho Kim, MD, Hye Seung Lee, MD

Published in: Annals of Surgical Oncology | Issue 1/2010

Login to get access

Abstract

Background

Prediction of lymph node metastasis in early gastric carcinoma (EGC) is important for management and follow-up of EGC patients. Increased lymphangiogenesis has been suggested to correlate with lymphatic invasion and lymph node metastasis in various tumors.

Methods

Lymphatic vessel density (LVD) and microvessel density (MVD) of 141 EGCs were determined by double immunohistochemical staining for D2-40 and CD31. The mean values of three to five hotspots were calculated in intratumoral and peritumoral areas in digital images.

Results

The mean value of intratumoral LVD in a lymph-node-positive EGC group was 28.24/field, which was significantly higher than in a lymph-node-negative EGC group (19.43/field, P = 0.005). Peritumoral LVD, intratumoral MVD, and peritumoral MVD did not correlate with lymph node metastasis in EGCs (P > 0.05). Intratumoral LVD did not show significant differences according to lymphatic invasion and differentiation, which were positive predictors for lymph node metastasis in EGC. Using multivariate logistic regression, intratumoral LVD was an independent factor, with the above two factors and depth of invasion, for the prediction of lymph node metastasis in EGC with a relative risk of 3.570 in high-intratumoral-LVD group compared with low-intratumoral-LVD group (P = 0.022).

Conclusion

Intratumoral LVD may be a useful, independent predictor for lymph node metastasis, especially in combination with previously established predictors in EGC.
Literature
1.
Yokota T, Ishiyama S, Saito T, Teshima S, Narushima Y, Murata K, et al. Lymph node metastasis as a significant prognostic factor in gastric cancer: a multiple logistic regression analysis. Scand J Gastroenterol. 2004;39:380–4.CrossRefPubMed
2.
Folli S, Morgagni P, Roviello F, De Manzoni G, Marrelli D, Saragoni L, et al. Risk factors for lymph node metastases and their prognostic significance in early gastric cancer (EGC) for the Italian Research Group for Gastric Cancer (IRGGC). Jpn J Clin Oncol. 2001;31:495–9.CrossRefPubMed
3.
Yokota T, Saito T, Teshima S, Yamada Y, Iwamoto K, Takahashi M, et al. Probability of lymph node metastasis in small gastric cancer tumor: is it an indication for limited surgery? Int Surg. 2001;86:206–9.PubMed
4.
An JY, Baik YH, Choi MG, Noh JH, Sohn TS, Kim S. Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg. 2007;246:749–53.CrossRefPubMed
5.
Maehara Y, Kabashima A, Koga T, Tokunaga E, Takeuchi H, Kakeji Y, et al. Vascular invasion and potential for tumor angiogenesis and metastasis in gastric carcinoma. Surgery. 2000;128:408–16.CrossRefPubMed
6.
Sako A, Kitayama J, Ishikawa M, Yamashita H, Nagawa H. Impact of immunohistochemically identified lymphatic invasion on nodal metastasis in early gastric cancer. Gastric Cancer. 2006;9:295–302.CrossRefPubMed
7.
Gombos Z, Xu X, Chu CS, Zhang PJ, Acs G. Peritumoral lymphatic vessel density and vascular endothelial growth factor C expression in early-stage squamous cell carcinoma of the uterine cervix. Clin Cancer Res. 2005;11:8364–71.CrossRefPubMed
8.
Kitadai Y, Kodama M, Cho S, Kuroda T, Ochiumi T, Kimura S, et al. Quantitative analysis of lymphangiogenic markers for predicting metastasis of human gastric carcinoma to lymph nodes. Int J Cancer. 2005;115:388–92.CrossRefPubMed
9.
Liu HD, Zhao LH, Zhang YF, Li YL, Li XD, Yang SC, et al. Morphologic features of lymphatic in periphery region of gastric carcinoma and colon carcinoma. Ai Zheng. 2005;24:699–703.PubMed
10.
Liang P, Hong JW, Ubukata H, Liu HR, Watanabe Y, Katano M, et al. Increased density and diameter of lymphatic microvessels correlate with lymph node metastasis in early stage invasive colorectal carcinoma. Virchows Arch. 2006;448:570–5.CrossRefPubMed
11.
Nakamura Y, Yasuoka H, Tsujimoto M, Kurozumi K, Nakahara M, Nakao K, et al. Importance of lymph vessels in gastric cancer: a prognostic indicator in general and a predictor for lymph node metastasis in early stage cancer. J Clin Pathol. 2006;59:77–82.CrossRefPubMed
12.
Roma AA, Magi-Galluzzi C, Kral MA, Jin TT, Klein EA, Zhou M. Peritumoral lymphatic invasion is associated with regional lymph node metastases in prostate adenocarcinoma. Mod Pathol. 2006;19:392–8.CrossRefPubMed
13.
Kaneko I, Tanaka S, Oka S, Kawamura T, Hiyama T, Ito M, et al. Lymphatic vessel density at the site of deepest penetration as a predictor of lymph node metastasis in submucosal colorectal cancer. Dis Colon Rectum. 2007;50:13–21.CrossRefPubMed
14.
Longatto-Filho A, Pinheiro C, Pereira SM, Etlinger D, Moreira MA, Jube LF, et al. Lymphatic vessel density and epithelial D2-40 immunoreactivity in pre-invasive and invasive lesions of the uterine cervix. Gynecol Oncol. 2007;107:45–51.CrossRefPubMed
15.
Yuanming L, Feng G, Lei T, Ying W. Quantitative analysis of lymphangiogenic markers in human gastroenteric tumor. Arch Med Res. 2007;38:106–12.CrossRefPubMed
16.
El-Gohary YM, Metwally G, Saad RS, Robinson MJ, Mesko T, Poppiti RJ. Prognostic significance of intratumoral and peritumoral lymphatic density and blood vessel density in invasive breast carcinomas. Am J Clin Pathol. 2008;129:578–86.CrossRefPubMed
17.
Gao P, Zhou GY, Zhang QH, Xiang L, Zhang SL, Li C, et al. Clinicopathological significance of peritumoral lymphatic vessel density in gastric carcinoma. Cancer Lett. 2008;263:223–30.CrossRefPubMed
18.
Van der Auwera I, Van den Eynden GG, Colpaert CG, Van Laere SJ, van Dam P, Van Marck EA, et al. Tumor lymphangiogenesis in inflammatory breast carcinoma: a histomorphometric study. Clin Cancer Res. 2005;11:7637–42.CrossRefPubMed
19.
Evangelou E, Kyzas PA, Trikalinos TA. Comparison of the diagnostic accuracy of lymphatic endothelium markers: Bayesian approach. Mod Pathol. 2005;18:1490–7.CrossRefPubMed
20.
Miettinen M, Lindenmayer AE, Chaubal A. Endothelial cell markers CD31, CD34, and BNH9 antibody to H- and Y-antigens—evaluation of their specificity and sensitivity in the diagnosis of vascular tumors and comparison with von Willebrand factor. Mod Pathol. 1994;7:82–90.PubMed
21.
Weidner N, Semple JP, Welch WR, Folkman J. Tumor angiogenesis and metastasis—correlation in invasive breast carcinoma. N Engl J Med. 1991;324:1–8.PubMed
22.
Mazumdar M, Smith A, Bacik J. Methods for categorizing a prognostic variable in a multivariable setting. Stat Med. 2003;22:559–71.CrossRefPubMed
23.
Japanese Gastric Cancer Association. Treatment guidelines for gastric carcinoma in Japan. 2nd ed. Tokyo: Kanehara; 2004.
24.
Ishikawa S, Togashi A, Inoue M, Honda S, Nozawa F, Toyama E, et al. Indications for EMR/ESD in cases of early gastric cancer: relationship between histological type, depth of wall invasion, and lymph node metastasis. Gastric Cancer. 2007;10:35–8.CrossRefPubMed
25.
Hall FT, Freeman JL, Asa SL, Jackson DG, Beasley NJ. Intratumoral lymphatics and lymph node metastases in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 2003;129:716–9.CrossRefPubMed
26.
Maula SM, Luukkaa M, Grenman R, Jackson D, Jalkanen S, Ristamaki R. Intratumoral lymphatics are essential for the metastatic spread and prognosis in squamous cell carcinomas of the head and neck region. Cancer Res. 2003;63:1920–6.PubMed
27.
Inoue A, Moriya H, Katada N, Tanabe S, Kobayashi N, Watanabe M, et al. Intratumoral lymphangiogenesis of esophageal squamous cell carcinoma and relationship with regulatory factors and prognosis. Pathol Int. 2008;58:611–9.CrossRefPubMed
28.
Zhao D, Pan J, Li XQ, Wang XY, Tang C, Xuan M. Intratumoral lymphangiogenesis in oral squamous cell carcinoma and its clinicopathological significance. J Oral Pathol Med. 2008;37:616–25.PubMed
29.
Listrom MB, Fenoglio-Preiser CM. Lymphatic distribution of the stomach in normal, inflammatory, hyperplastic, and neoplastic tissue. Gastroenterology. 1987;93:506–14.PubMed
30.
Williams CS, Leek RD, Robson AM, Banerji S, Prevo R, Harris AL, et al. Absence of lymphangiogenesis and intratumoural lymph vessels in human metastatic breast cancer. J Pathol. 2003;200:195–206.CrossRefPubMed
31.
Straume O, Jackson DG, Akslen LA. Independent prognostic impact of lymphatic vessel density and presence of low-grade lymphangiogenesis in cutaneous melanoma. Clin Cancer Res. 2003;9:250–6.PubMed
32.
Ding S, Li C, Lin S, Yang Y, Liu D, Han Y, Zhang Y, et al. Comparative evaluation of microvessel density determined by CD34 or CD105 in benign and malignant gastric lesions. Hum Pathol. 2006;37:861–6.CrossRefPubMed
33.
Che X, Hokita S, Natsugoe S, Tanabe G, Baba M, Takao S, et al. Tumor angiogenesis related to growth pattern and lymph node metastasis in early gastric cancer. Chin Med J (Engl). 1998;111:1090–3.
34.
Cao Y. Opinion: emerging mechanisms of tumour lymphangiogenesis and lymphatic metastasis. Nat Rev Cancer. 2005;5:735–43.CrossRefPubMed
35.
Altman DG, Lausen B, Sauerbrei W, Schumacher M. Dangers of using “optimal” cutpoints in the evaluation of prognostic factors. J Natl Cancer Inst. 1994;86:829–35.CrossRefPubMed
Metadata
Title
Increased Intratumoral Lymphatic Vessel Density Correlates with Lymph Node Metastasis in Early Gastric Carcinoma
Authors
Kyoungbun Lee, MD
Do Joong Park, MD
Gheeyoung Choe, MD
Hyung Ho Kim, MD
Woo Ho Kim, MD
Hye Seung Lee, MD
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0707-y

Other articles of this Issue 1/2010

Annals of Surgical Oncology 1/2010 Go to the issue

Colorectal Cancer

Searching for a Cutoff Value for Lymph Nodes Retrieved as a Quality Control of Surgery and Pathology in Colon Cancer

Reconstructive Oncology

Immediate Microsurgical Reconstruction After Tumor Ablation Predicts Survival Among Patients with Head and Neck Carcinoma

Gastrointestinal Oncology

High-Level Expression of S100A4 Correlates with Lymph Node Metastasis and Poor Prognosis in Patients with Gastric Cancer

Hepatobiliary Tumors

Liver Resection for Metastatic Melanoma with Postoperative Tumor-Infiltrating Lymphocyte Therapy

Breast Oncology

The Effects of Additional Tumor Cavity Sampling at the Time of Breast-Conserving Surgery on Final Margin Status, Volume of Resection, and Pathologist Workload

Gynecologic Oncology

Prognostic Impact of Additional Extended Surgical Procedures in Advanced-Stage Primary Ovarian Cancer