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High density of peritumoral lymphatic vessels measured by D2-40/podoplanin and LYVE-1 expression in gastric cancer patients: an excellent prognostic indicator or a false friend?

Rudno-Rudzinska J, Kielan W, Grzebieniak Z, Dziegiel P, Donizy P, Mazur G, Knakiewicz M, Frejlich E, Halon A - Gastric Cancer (2012)

Bottom Line: Statistical analysis showed no impact of increased intratumoral or peritumoral LVD on gastric cancer patient survival, irrespective of the protein used to stain lymphatic vessels.Analysis showed that the probability of overall survival was decreased in the cases with enhanced VEGF-D immunoreactivity (P = 0.0045).VEGF-D is the only marker that can be regarded as an unfavorable prognostic indicator for patients with advanced gastric cancer.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of General and Oncological Surgery, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland, jrr@id.pl.

ABSTRACT

Background: One of the most important prognostic indicators in gastric cancer is the presence of metastases in lymph nodes. Even now, little is known about lymphangiogenesis in neoplastic tissue, and little is also known about the transmission of a neoplastic cell from the tumor mass into a lymphatic vessel.

Methods: This study examined the relationships between the density of lymphatic vessels (LVD) stained immunohistochemically with lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) and D2-40 (podoplanin) antibodies, the expression of vascular endothelial growth factor (VEGF)-C/D, selected clinical and pathomorphological factors, and the 5-year overall survival of gastric cancer patients.

Results: Statistical analysis showed no impact of increased intratumoral or peritumoral LVD on gastric cancer patient survival, irrespective of the protein used to stain lymphatic vessels. Analysis showed that the probability of overall survival was decreased in the cases with enhanced VEGF-D immunoreactivity (P = 0.0045).

Conclusion: The study showed that the studied markers cannot be used to determine the required extent of the surgical procedure, as they have no statistically significant correlation with the degree of progression of the cancer, the stage of the disease assessed according to the TNM 5th classification of malignant tumors, clinicopathological features, and patient survival. VEGF-D is the only marker that can be regarded as an unfavorable prognostic indicator for patients with advanced gastric cancer.

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Lymphatic vessel density stained with D2-40 (podoplanin) and lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1). Expression of D2-40 in intratumoral compartment (a) and peritumoral zone (b); expression of LYVE-1 in intratumoral area (c) and peritumoral zone (d). a, b ×100; c, d ×200
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Fig1: Lymphatic vessel density stained with D2-40 (podoplanin) and lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1). Expression of D2-40 in intratumoral compartment (a) and peritumoral zone (b); expression of LYVE-1 in intratumoral area (c) and peritumoral zone (d). a, b ×100; c, d ×200

Mentions: Lymphatic vessels stained with D2-40 marker were visible throughout neoplastic tissue without a distinct borderline. The mean LVD (lymph vessel density) in neoplastic tissue within the field of view was 6.5 (minimum, 0; maximum, 21.7) (Fig. 1a). Podoplanin-stained lymphatic vessels were also found in the peritumoral zone. Their density there was statistically significantly higher (Wilcoxon test: Z = 3.4, P = 0.0007) than that within the tumor, and on average amounted to 8.8 vessels within one field of view. The smallest number of vessels for this range was 1.1 and the largest 23.1 (Fig. 1b).Fig. 1


High density of peritumoral lymphatic vessels measured by D2-40/podoplanin and LYVE-1 expression in gastric cancer patients: an excellent prognostic indicator or a false friend?

Rudno-Rudzinska J, Kielan W, Grzebieniak Z, Dziegiel P, Donizy P, Mazur G, Knakiewicz M, Frejlich E, Halon A - Gastric Cancer (2012)

Lymphatic vessel density stained with D2-40 (podoplanin) and lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1). Expression of D2-40 in intratumoral compartment (a) and peritumoral zone (b); expression of LYVE-1 in intratumoral area (c) and peritumoral zone (d). a, b ×100; c, d ×200
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3824260&req=5

Fig1: Lymphatic vessel density stained with D2-40 (podoplanin) and lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1). Expression of D2-40 in intratumoral compartment (a) and peritumoral zone (b); expression of LYVE-1 in intratumoral area (c) and peritumoral zone (d). a, b ×100; c, d ×200
Mentions: Lymphatic vessels stained with D2-40 marker were visible throughout neoplastic tissue without a distinct borderline. The mean LVD (lymph vessel density) in neoplastic tissue within the field of view was 6.5 (minimum, 0; maximum, 21.7) (Fig. 1a). Podoplanin-stained lymphatic vessels were also found in the peritumoral zone. Their density there was statistically significantly higher (Wilcoxon test: Z = 3.4, P = 0.0007) than that within the tumor, and on average amounted to 8.8 vessels within one field of view. The smallest number of vessels for this range was 1.1 and the largest 23.1 (Fig. 1b).Fig. 1

Bottom Line: Statistical analysis showed no impact of increased intratumoral or peritumoral LVD on gastric cancer patient survival, irrespective of the protein used to stain lymphatic vessels.Analysis showed that the probability of overall survival was decreased in the cases with enhanced VEGF-D immunoreactivity (P = 0.0045).VEGF-D is the only marker that can be regarded as an unfavorable prognostic indicator for patients with advanced gastric cancer.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of General and Oncological Surgery, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland, jrr@id.pl.

ABSTRACT

Background: One of the most important prognostic indicators in gastric cancer is the presence of metastases in lymph nodes. Even now, little is known about lymphangiogenesis in neoplastic tissue, and little is also known about the transmission of a neoplastic cell from the tumor mass into a lymphatic vessel.

Methods: This study examined the relationships between the density of lymphatic vessels (LVD) stained immunohistochemically with lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) and D2-40 (podoplanin) antibodies, the expression of vascular endothelial growth factor (VEGF)-C/D, selected clinical and pathomorphological factors, and the 5-year overall survival of gastric cancer patients.

Results: Statistical analysis showed no impact of increased intratumoral or peritumoral LVD on gastric cancer patient survival, irrespective of the protein used to stain lymphatic vessels. Analysis showed that the probability of overall survival was decreased in the cases with enhanced VEGF-D immunoreactivity (P = 0.0045).

Conclusion: The study showed that the studied markers cannot be used to determine the required extent of the surgical procedure, as they have no statistically significant correlation with the degree of progression of the cancer, the stage of the disease assessed according to the TNM 5th classification of malignant tumors, clinicopathological features, and patient survival. VEGF-D is the only marker that can be regarded as an unfavorable prognostic indicator for patients with advanced gastric cancer.

Show MeSH
Related in: MedlinePlus