Prognostic Significance of Intratumoral and Peritumoral Lymphatic Density and Blood Vessel Density in Invasive Breast Carcinomas

El-Gohary, Yasser; Metwally, Ghada; Robinson, Morton J.; Mesko, Thomas W.; Poppiti, Robert

doi:10.1309/2hgnj1gu57jmbjaq

Cited by 69 publications

(62 citation statements)

References 33 publications

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“…It has been previously reported that LVD and MVD also result in poor prognosis in invasive ductal carcinoma (IDC) and colorectal cancer (Saad et al, 2006;El-Gohary et al, 2008), which is consistent with the results of this study. Therefore, D2-40 and CD34 are crucial to the generation and development of gastric cancer and may be used as effective indices to evaluate gastric cancer invasion, metastasis and prognosis.…”

Section: Discussionsupporting

confidence: 93%

Lymphangiogenic and Angiogenic Microvessel Density in Chinese Patients with Gastric Carcinoma: Correlation with Clinicopathologic Parameters and Prognosis

Cao

Hu²,

Li³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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The incidence of gastric cancer worldwide, and in particular in developing countries, has shown a marked increase. Poor prognosis of gastric cancer patients occurs due to the rapid metastasis of the disease via the lymphatic and blood vessels. The aim of this study was to investigate the expression and the clinical significance of D2-40 and CD34 in human gastric cancer. D2-40 and CD34 expression wasdetected in 1,072 cases of Chinese patients with gastric carcinoma using immunohistochemistry. The lymphatic vessel density (LVD) and microvessel density (MVD) were calculated and analyzed and the correlation with the clinicopathological factors and prognosis was determined. The LVD and MVD of the gastric cancer cases were significantly higher compared to those of normal tissues (P < 0.05). The expression of D2-40-LVD and CD34-MVD in the malignancies were positively related to the age, tumor size, invasion depth, lymphatic metastasis and pathological tumor-node-metastasis (pTNM) (P < 0.05); However, no statistically significant difference was identified between them with the patient gender (P > 0.05). Up-regulation of D2-40 and CD34 expression was significantly correlated with the poor survival rate in univariate and multivariate analyses. The LVD marked by D2-40 and the MVD marked by CD34 were positively correlated to the clinicopathological factors of the malignancies and may play important role in the development and progression of gastric cancer.

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Section: Discussionsupporting

confidence: 93%

Lymphangiogenic and Angiogenic Microvessel Density in Chinese Patients with Gastric Carcinoma: Correlation with Clinicopathologic Parameters and Prognosis

Cao

Hu²,

Li³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…[11][12][13] Although the significance of lymphatic vessel density is still unclear, it was proposed that tumor cells exposed to more lymphatic vessels are more likely to spread to lymph nodes and to distant sites. 21 Similar to previous studies, 6,26 we found that the presence of intratumor lymphatic vessels could be demonstrated in almost 50% of invasive breast carcinomas; however, the number of peritumor lymphatic vessels was significantly higher. As previously described in cervical and other cancers, 5,19 intratumor lymphatic vessels were characteristically small and flattened with a close lumen in contrast with the typically widely open, dilated lymphatics in peritumor regions.…”

Section: Discussionsupporting

confidence: 90%

The extent of retraction clefts correlates with lymphatic vessel density and VEGF-C expression and predicts nodal metastasis and poor prognosis in early-stage breast carcinoma

et al. 2012

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Although the earliest feature of disseminated disease in breast cancer is regional lymph node involvement, little is known about the mechanisms whereby cancer cells interact with lymphatic endothelial cells and enter the lymphatic system. We have previously reported that the extensive presence of retraction clefts in breast carcinomas highly significantly correlates with lymphatic tumor spread and predicts poor outcome, suggesting that retraction clefts are not just fixation artifacts, but real potential spaces that are exaggerated by tissue processing and may reflect an early stage of lymphatic invasion. In this study, we examined the correlation between the extent of retraction clefts and lymphangiogenesis, as assessed by lymphatic vessel density and vascular endothelial growth factor-C (VEGF-C) expression in a series of 256 early-stage breast carcinomas. The presence and extent of retraction clefts around tumor cell nests was determined by review of all hematoxylinand eosin-stained tumor sections. Lymphatic vessels were detected by podoplanin immunohistochemistry and lymphatic vessel density was measured using the hot-spot method. The expression of VEGF-C in the tumor cells was determined by immunohistochemistry and analyzed semiquantitatively on a four-tiered scale. High levels of retraction clefts, peritumor lymphatic vessel density and VEGF-C expression at the invasive edge in breast carcinomas significantly correlated with tumor size, histological grade, lymphatic invasion and nodal metastasis. Breast carcinomas showing extensive retraction clefts (420% of tumor volume) were found to have significantly higher lymphatic vessel density and VEGF-C expression levels compared to tumors without this feature. High retraction clefts, peritumor lymphatic vessel density and VEGF-C expression predicted poor outcome in breast carcinomas. Our results support the hypothesis that retraction clefts are real potential spaces that may represent 'pre-lymphatic spaces' facilitating initial lymphatic invasion and that growth factors secreted by the tumor cells may stimulate tumor-associated lymphangiogenesis by promoting the endothelialization of these 'pre-lymphatic channels'.

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“…Similar result was found by Schoppmann et al (2004) but not by El Ghohary et al (2008). In breast cancer, tumor size is the most powerful predictor for local recurrence, regional and systemic spread, therefore for overall survival.…”

Section: Discussionsupporting

confidence: 83%

Clinicopathological Significance of Lymphangiogenesis and Tumor Lymphovascular Invasion in Indonesian Breast Cancers

Widodo

Ferronika²,

Harijadi³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Prognostic Significance of Intratumoral and Peritumoral Lymphatic Density and Blood Vessel Density in Invasive Breast Carcinomas

Cited by 69 publications

References 33 publications

Lymphangiogenic and Angiogenic Microvessel Density in Chinese Patients with Gastric Carcinoma: Correlation with Clinicopathologic Parameters and Prognosis

Lymphangiogenic and Angiogenic Microvessel Density in Chinese Patients with Gastric Carcinoma: Correlation with Clinicopathologic Parameters and Prognosis

The extent of retraction clefts correlates with lymphatic vessel density and VEGF-C expression and predicts nodal metastasis and poor prognosis in early-stage breast carcinoma

Clinicopathological Significance of Lymphangiogenesis and Tumor Lymphovascular Invasion in Indonesian Breast Cancers

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