Vascular Invasion is Underrecognized in Colorectal Cancer Using Conventional Hematoxylin and Eosin Staining

Abstract

This study was novel in that it compared both histochemical and immunohistochemical methods for identifying vascular invasion in cases of colorectal cancer in which vascular invasion had not been identified during initial reporting. Highlighting of endothelium significantly increases the observed incidence of vascular invasion in colorectal cancer compared with hematoxylin and eosin alone. Elastic van gieson seemed sensitive for the presence of vascular invasion but with uncertain specificity. The possibility that these immunohistochemical methods may identify a subset of patients with colorectal cancer who may benefit from chemotherapy warrants further study.

The Factors Effecting Lymphovascular Invasion in Adenocarcinoma of the Colon and Rectum

“…The perineural invasion, pT, and peritumoral lymphocytic infiltration were the factors with p<0.2 in the univariate analysis on lymphovascular invasion that were analyzed in logistic regression multivariate analysis. No factors are statistically related to lymphovascular invasion; p<0.05 was accepted significant SE standard error LVI could be recognized clearly on hematoxylin and eosin (H&E)-stained slides, despite the fact that some reports indicate that immunohistochemical stains with CD31 and D2-40 may improve the diagnosis [18,19]. CD31 is a marker of endothelial cells and is also designated as "platelet endothelial cell adhesion molecule-1" (PECAM-1).…”

Vascular invasion is an early event in pathogenesis of Merkel cell carcinoma

“…Our series confirms that immunohistochemistry, using specific marker, increases the sensitivity of detecting vascular invasion in Merkel cell carcinoma, as has been shown in other types of cancer as well. [32][33][34] Furthermore, in the earlier studies on Merkel cell carcinoma and vascular invasion, no distinction was made between lymphovascular and blood vascular structures. We used D2-40, which is a sensitive and specific marker for lymphatic endothelia.…”

Vascular invasion detected by orcein staining and its significance in different tumours, with emphasis on colorectal cancer

“…Endothelium, which is specific to vascular structures, can be highlighted by immunohistochemical markers. Factor VIII-related antigen, CD31 and CD34 are used to highlight lymphatic as well as blood vessel endothelial cells [10]. On H&E-stained slides, no reliable distinction can be made between lymphatic and blood vessels.…”

“…On average, a threefold increase in the VI detection rate was experienced in some studies comparing H&E and elastic stains (Table 11) [10,12,25,30,[40][41][42]. In this setting, tumour cells surrounded by an elastic lamina are considered VI.…”

“…Metastases in more than one organ/site or the peritoneum Elastica stainings are reported to be useful in the evaluation of VI in colorectal [7][8][9][10][11][12], gastric [13,14] and oesophageal cancers [15]. The use of elastica stains can provide a more precise identification of VI in CRC compared to routine haematoxylin and eosin (H&E) stain.…”