Grading system of lymphatic invasion according to D2‐40 immunostaining is useful for the prediction of nodal metastasis in squamous cell carcinoma of the uterine cervix

Urabe, Atsumichi; Matsumoto, Takeshi; Kimura, M.; Sonoue, Hiroshi; Kinoshita, Kazuo

doi:10.1111/j.1365-2559.2006.02536.x

Cited by 40 publications

(22 citation statements)

References 6 publications

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“…As D2-40 is a highly specific lymphatic endothelial marker, our results should be more reliable compared with the conventional HE-staining method. Using the same antibody as that employed here, Urabe et al (2006) have reported that the LVI detection rate is 65.3 %, which is obviously higher than our observation. This discrepancy might be attributable to the difference in the number of blocks studied for each patient between the two studies, as an average of 5.7 (range: 2-6) blocks for each patient was cut and evaluated in the study of Urabe et al (2006).…”

Section: Discussioncontrasting

confidence: 82%

“…Using the same antibody as that employed here, Urabe et al (2006) have reported that the LVI detection rate is 65.3 %, which is obviously higher than our observation. This discrepancy might be attributable to the difference in the number of blocks studied for each patient between the two studies, as an average of 5.7 (range: 2-6) blocks for each patient was cut and evaluated in the study of Urabe et al (2006). In our investigation, we have found that LVI is not correlated to the progression and prognosis of squamous cell cervical cancer but is positively correlated to LVD.…”

Section: Discussioncontrasting

confidence: 82%

“…The newly developed D2-40 antibody reacts with the carcinoembryonic antigen M2A in ovarian cancer cell lines and germ cell tumors (Roy et al 2005). This D2-40 antibody has been suggested to be suitable for the identification of lymphatic vessel invasion in a variety of malignant tumors, including cervical cancer, whereas no immunoreactions with vascular endothelial cells are observed (Yonemura et al 2006;Urabe et al 2006). Hence, this antibody can be used as a highly sensitive and specific lymphatic endothelial marker.…”

Section: Discussionmentioning

confidence: 96%

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Clinical significance of peritumoral lymphatic vessel density and lymphatic vessel invasion detected by D2-40 immunostaining in FIGO Ib1-IIa squamous cell cervical cancer

et al. 2012

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The clinical significance of lymphangiogenesis in cervical cancer remains controversial. Our aim was to investigate the correlation between lymphangiogenesis, lymphatic vessel invasion (LVI) and tumor metastasis, invasion and prognosis in squamous cell cervical cancer. Paraffin sections of 90 patients with FIGO (Fédération Internationale de Gynécologie et d'Obstétrique) Ib1-IIa squamous cell cervical cancer were stained for immunohistochemistry with a D2-40 monoclonal antibody against the carcinoembryonic antigen M2A. The lymphatic vessel density (LVD) and LVI were measured, and their relationship with the clinicopathological data was analyzed. D2-40-positive lymphatic vessels were found in 75 of the 90 patients (83.3 %). All D2-40-positive vessels were located in peritumoral areas. The mean±SD of the peritumoral LVD was 10.08±4.16. The positive rate of LVI was 32.0 % (24/75). The recurrence rate of patients with LVD >10 (62.1 %, 18/29) was significantly higher than that of patients with LVD ≤10 (34.8 %, 16/46, P = 0.021). The 5-year recurrence-free survival rate of patients with LVD >10 (41.0 %) was significantly lower than that of patients with LVD ≤10 (67.0 %, P = 0.045). Univariate analysis showed that the peritumoral LVD (≤10 vs >10) was correlated with LVI (absent vs present, P = 0.016). The peritumoral LVD and LVI showed no correlation with age, FIGO stage, tumor size, tumor grade, depth of invasion, or pelvic lymph node metastasis (all: P > 0.05). Peritumoral lymphangiogenesis was correlated with the recurrence and recurrence-free survival in patients with squamous cell cervical cancer. Examination of peritumoral LVD in these patients might therefore help to estimate the risk of recurrence.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 96%

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Clinical significance of peritumoral lymphatic vessel density and lymphatic vessel invasion detected by D2-40 immunostaining in FIGO Ib1-IIa squamous cell cervical cancer

et al. 2012

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“…45 Obviously, we need a more reliable and objective method to determine the presence and degree of LVSI, using immunohistochemical techniques. 46 Tumor and molecular markers of lymph node metastasis Tumor markers are related to lymph node metastasis. Takeshima et al 47 showed that patients with elevated serum squamous cell carcinoma (SCC) levels were at high risk for 48 found that the serum SCC level and carbohydrate antigen (CA) 125 level were independently correlated to lymph node metastasis.…”

Section: Figo Stagementioning

confidence: 99%

Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer

Sakuragi

2007

Int J Clin Oncol

121

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Lymph node metastasis (LNM), together with parametrial infiltration and positive surgical margins, is an important prognostic factor in cervical cancer. The incidence of LNM increases with International Federation of Gynecology and Obstetrics (FIGO) stage, with rates being 12%-22% in stage Ib, 10%-27% in stage IIa, and 34%-43% in stage IIb. Radical hysterectomy and pelvic lymphadenectomy are widely used treatments for early-stage (Ib to IIa) cervical cancer, as well as for stage IIb disease, in some European and Asian countries. In several types of cancer, the therapeutic significance of systematic lymphadenectomy has been demonstrated by recent reports showing that a larger number of lymph nodes removed relates to better survival. In cervical cancer, a significant relationship between the number of lymph nodes removed and disease-free survival has been reported in node-positive patients. Preoperative evaluation of nodal status with computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) imaging techniques is not sensitive enough to replace the histological examination of dissected nodes. The sentinel node procedure may be an alternative to systematic lymphadenectomy to reduce treatment-related morbidity, but more work on this is needed. Although the presence of LNM does not change FIGO staging, it will modulate postoperative therapy. Progression-free and overall survivals were significantly improved by the addition of chemotherapy to adjuvant radiotherapy after radical hysterectomy and lymphadenectomy. Adjuvant chemotherapy combined solely with radical hysterectomy and systematic lymphadenectomy may also provide a survival benefit. In conclusion, efforts to establish more tailored surgical strategies, by introducing advanced imaging technologies and molecular diagnostic procedures, are needed for cervical cancer.

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“…No data about the origin of lymph vessels, the prognostic impact of lymphangiogenesis in precursor lesions of the uterine cervix, or their involvement in nodal pelvic metastasis development have been confirmed. Available data about lymphatic vessels (LV) in tumors of the uterine cervix are scattered and controversial, and moreover, there are almost no references regarding lymphangiogenesis in precursor lesions and also for the normal cervix [10,11].…”

Section: Introductionmentioning

confidence: 99%

Shadow Keyplayers of the Uterine Cervix Lesions Progression and Metastasis

Cîmpean¹,

Mazuru²,

Lilian³

et al. 2012

Histopathology - Reviews and Recent Advances

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Grading system of lymphatic invasion according to D2‐40 immunostaining is useful for the prediction of nodal metastasis in squamous cell carcinoma of the uterine cervix

Abstract: In cervical SCC, a grading system for lymphatic invasion according to D2-40 immunostaining is useful for the prediction of nodal metastasis and grade 2 lymphatic invasion is a strong predictor of nodal metastasis.

Cited by 40 publications

References 6 publications

Clinical significance of peritumoral lymphatic vessel density and lymphatic vessel invasion detected by D2-40 immunostaining in FIGO Ib1-IIa squamous cell cervical cancer

Clinical significance of peritumoral lymphatic vessel density and lymphatic vessel invasion detected by D2-40 immunostaining in FIGO Ib1-IIa squamous cell cervical cancer

Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer

Shadow Keyplayers of the Uterine Cervix Lesions Progression and Metastasis

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