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. 2010 Apr 8:10:131.
doi: 10.1186/1471-2407-10-131.

High density of peritumoral lymphatic vessels is a potential prognostic marker of endometrial carcinoma: a clinical immunohistochemical method study

Ying Gao  1 , Zi Liu, Fei Gao, Xiao-yu Meng
Affiliations

High density of peritumoral lymphatic vessels is a potential prognostic marker of endometrial carcinoma: a clinical immunohistochemical method study

Ying Gao et al. BMC Cancer. .

Abstract

Background: The lymphatic system is a major route for cancer cell dissemination and also a potential target for antitumor therapy. To investigate whether increased lymphatic vessel density (LVD) is a prognostic factor for nodal metastasis and survival, we studied peritumoral LVD (P-LVD) and intratumoral LVD (I-LVD) in samples from 102 patients with endometrial carcinoma;

Methods: Endometrial carcinoma tissues were analyzed for lymphatic vessels by immunohistochemical staining with an antibody against LYVE-1. Univariate analysis was performed with Kaplan-Meier life-table curves to estimate survival, and was compared using the log rank test. Prognostic models used multivariate Cox regression analysis for multivariate analyses of survival;

Results: Our study showed that P-LVD, but not I-LVD, was significantly correlated with lymph vascular space invasion (LVSI), lymph node metastasis, tumor stage, and CD44 expression in endometrial carcinoma. Moreover, P-LVD was an independent prognostic factor for progression-free survival and overall survival of endometrial carcinoma;

Conclusions: P-LVD may serve as a prognostic factor for endometrial carcinoma. The peritumoral lymphatics might play an important role in lymphatic vessel metastasis.

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Figures

Figure 1
Figure 1
a LYVE-1, normal endometrial tissue (NE), 200×. b LYVE-1, periphery regions in endometrial carcinoma (EC) tissue, 200×. c LYVE-1, intratumoral regions in endometrial carcinoma (EC) tissue, 200×. LYVE-1 expression was restricted to irregular shaped endothelial cells without a thick-walled structure. Number of lymphatic vessels was much higher in periphery tumour than intratumoral regions (b and c). d The staining of CD44, normal endometrial tissue (NE), 200×. e CD44, in endometrial carcinoma (EC) tissue without LYVE1+ lymphatic vessels, 200×. f CD44, in endometrial carcinoma (EC) tissue with LYVE1+lymphatic vessels, 200×. The staining of CD44 was stronger in endometrial carcinoma (EC) tissue with LYVE1+lymphatic vessels than without LYVE1+ lymphatic vessels (e and f).
Figure 2
Figure 2
Survival analysis of increased P-LVD and I-LVD in endometrial carcinoma. a Overall-survival curve stratified for increased versus decreased P-LVD (P < 0.01). b Progression-free survival curve stratified for increased versus decreased P-LVD (P < 0.01). c Overall-survival curve stratified for increased versus decreased I-LVD (P > 0.05). d Progression-free survival curve stratified for increased versus decreased I-LVD (P > 0.05).
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