Lateral peritumoral lymphatic vessel invasion can predict lymph node metastasis in esophageal squamous cell carcinoma

Abstract

Lymph node metastasis is an important prognostic factor in many types of cancer. We investigated the clinical significance of lymphangiogenesis and lymphatic vessel invasion in esophageal squamous cell carcinoma. We evaluated lymphatic vessel density and lymphatic vessel invasion in the intratumoral, peritumoral and normal compartments using D2-40 immunostaining. In addition, the peritumoral compartment was divided into the lateral peritumoral compartment and the non-lateral peritumoral compartment. The lymphatic vessel density was higher in the peritumoral and intratumoral compartments than in the normal compartment. However, the lymphatic vessel density did not correlate with any pathological parameters including lymph node metastasis. Intratumoral and peritumoral lymph vessels were small and collapsed while normal lymphatic vessels and lymphatic vessels with lymphatic vessel invasion were dilated and large. The presence of lymphatic vessel invasion, in the lateral peritumoral compartment but nowhere else, significantly correlated with lymph node metastasis. These results suggest that lymphangiogenesis might occur with esophageal cancer, but it does not play a direct role in lymphatic vessel invasion and lymph node metastasis. Peritumoral lymphatic vessel invasion, especially in the lateral peritumoral compartment, should imply a high probability of regional lymph node metastasis.

THORACIC SURGERY Intratumoral lymphatic vessel density, and intratumoral and peritumoral lymphatic vessel invasion as predictive factors of lymph node metastasis and prognostic factors in esophageal cancer

“…We observed that intratumoral lymphatics were disorganized, small and flattened in contrast with the widely open lymphatics in peritumoral regions. This was in accordance with previous studies which investigated tumor-associated lymphangiogenesis using the same antibody in head and neck, and esophageal cancer [14,15].…”

Mucosal lymphatic vessels of the esophagus distant from the cancer margin: morphometrical analysis using 27 surgically removed specimens of squamous cell carcinoma located in the upper or middle thoracic esophagus

“…1, 5,6) However, the present numbers of lymphatic vessels were almost identical with the data obtained using a ×400 objective field. Thus, at a site 10 cm anal to a cancer, the numerical density may be much smaller than that in the cancer site although, to our regret, we have no data at and around the cancer.…”

“…1A). Conversely, for the present aim, cross-sectional histology was considered better because, in previous studies, 5,6,7,10) the morphometry had been p erformed on cross-sections. Therefore, the longitudinal paraffin blocks were melted and the specimens were reembedded to allow transverse sections (6 μm thick) to be cut.…”

“…4) In this context, many research groups have focused on individual differences in lymphatic vessel density among patients with esophageal squamous cell carcinoma. 5,6,7) These studies have revealed that lymphatic density is s ignificantly correlated with nodal involvement, and thus possibly with prognosis. However, to our knowledge, no previous study has investigated whether certain individual differences in lymphatic vessel morphology are present in the esophagus distant from the cancer, although systemic changes in lymphatics other than those of the esophagus have been suggested in cancer patients.…”

Lymphatic invasion and angiotropism in primary cutaneous melanoma

“…In addition, lymphatic invasion has been shown to be an unfavorable factor in other cancer types. [3][4][5][6] However, despite multiple studies, controversy remains regarding the clinical relevance of lymphatic invasion in melanoma. As yet, it is not a criterion for pathologic staging, although the presence of lymphatic invasion may prompt SLN biopsy in patients with thin melanoma.…”