VEGF-D in association with VEGFR-3 promotes nodal metastasis in human invasive lobular breast cancer

We assessed the expression of vascular endothelial growth factors (VEGF-C and VEGF-D) in breast cancer cells and the density of lymph vessels and VEGF receptor-3 (VEGFR-3)-positive vessels in and around the tumor in invasive lobular breast cancer. We found significant correlation between peritumoral lymph vessel density and presence of lymph node metastases (P=.001) and the number of metastatic lymph nodes (P<.001). A significant correlation was detected between tumor cell VEGF-D expression and lymph node status (P=.001) and density of lymphatic vessel endothelial receptor (LYVE)-1-positive vessels (P=.035). VEGFR-3+/VEGF-D+ and VEGFR-3+/VEGF-C+ tumors had a significantly higher number of metastatic lymph nodes than tumors with other staining patterns (P<.001). Tumors positive for neither VEGF-D nor VEGFR-3 had a lower density of LYVE-1+ vessels than tumors with other staining patterns (P=.033). Our results indicate that peritumoral lymph vessel density is associated with lymph node metastases in invasive lobular breast cancer and that invasive lobular cancer producing VEGF-D, surrounded by VEGFR-3+ vessels, has a significantly higher peritumoral lymph vessel density and a higher number of metastatic lymph nodes.     

血管内皮生长因子D和血管内皮生长因子受体3在人结肠癌中的表达及淋巴道转移中的作用

目的 观察血管内皮生长因子D(VEGF-D)和血管内皮生长因子受体3(VEGFR-3)在人结肠癌组织中的表达,检测结肠癌组织中的微淋巴管密度(LMVD),探讨VEGF-D和VEGFR-3在淋巴管生成以及结肠癌淋巴道转移中的作用.方法 选择55例不同时期,不同分化程度的人结肠癌组织样本,应用免疫组织化学染色的方法,观察VEGF-D和VEGFR-3在人结肠癌组织中的表达,应用Podoplanin标记淋巴管,检测结肠癌组织中的淋巴管密度.结果 在55例结肠癌组织中,VEGF-D的阳性表达率为54.5%,明显高于在癌周正常组织内的表达(P＜0.05);结肠癌组织中VEGFR-3表达的阳性率为69.1%,明显高于在癌周正常组织内的表达(P＜0.01);并且VEGFR-3的表达与VEGF-D的表达具有显著相关性(P＜0.01).在结肠癌组织中,淋巴结转移阳性组,浸润深度超过肌层组,DukeC、D期的VEGF-D的表达水平和LMVD明显高于淋巴结转移阴性组,浸润深度未超过肌层组,Duke A、B期(P＜0.01),经计数淋巴管数量,癌组织中的LMVD明显高于癌周正常组织(P＜0.01),并且LMVD与VEGF-D的表达显著相关(P＜0.01).结论 结肠癌组织中VEGF-D的表达水平随着癌的浸润和转移程度的增强而增高,并且通过上调其受体VEGFR-3的表达而促进癌组织中淋巴管的生成,从而促进癌的浸润和转移.     

Lymphatic vessel density in pulmonary adenocarcinoma immunohistochemically evaluated with anti-podoplanin or anti-D2-40 antibody is correlated with lymphatic invasion or lymph node metastases

In lung cancers, lymph node metastasis of cancer cells is one of the most important prognostic factors, and lymphatic vessel invasion (LVI) is very important in the stage preceding lymph node metastases. Recently, it has been reported that lymphatic vessel density (LVD) is associated with lymph node metastasis. The aim of the present study was to evaluate the relationship between LVD and LVI based on the immunohistochemical expression of podoplanin or D2-40, which are new specific markers for lymphatic endothelium. Using 76 cases of pulmonary adenocarcinoma, the relationship between LVD and LVI, lymph node metastases, vascular endothelial growth factor C (VEGF-C), VEGF-D or hepatocyte growth factor (HGF) expression was investigated. LVD was significantly associated with LVI, lymph node metastases and VEGF-D expression. LVI was also associated with lymph node metastases, histological subtype, VEGF-C or VEGF-D expression. High LVD, induced by VEGF-C or VEGF-D expression of cancer cells, is a good indicator of lymphatic metastases and LVI in pulmonary adenocarcinoma.     

血管内皮生长因子C及其受体3在人恶性黑色素瘤组织内的表达及意义

目的 观察人恶性黑色素瘤组织内血管内皮生长因子C(VEGF-C)及其受体3(VEGFR-3)的表达,探讨VEGF-C和VEGFR-3在恶性黑色素瘤淋巴管生成及淋巴道转移中的作用.方法 取人恶性黑色素瘤组织48例(石蜡标本30例,术后新鲜组织18例),应用免疫组织化学和RT-PCR技术,观察VEGF-C和VEGFR-3蛋白及mRNA在恶性黑色素瘤组织内的表达情况.以淋巴管内皮透明质酸受体(LYVE-1)标记淋巴管,计数恶性黑色素瘤组织淋巴管数密度.结果 VEGF-C和VEGFR-3蛋白主要表达于恶性黑色素瘤细胞胞浆内,在肿瘤周围的血管和淋巴管内皮上也可见VEGFR-3蛋白表达,VEGF-C和VEGFR-3蛋白在淋巴结转移组恶性黑色素瘤组织内的表达水平明显高于无淋巴结转移组(P<0.05).在18例新鲜恶性黑色素瘤中,淋巴结转移组VEGF-C和VEGFR-3mRNA的表达明显高于无淋巴结转移组(P<0.01).LYVE-1表达于肿瘤间质内的淋巴管内皮细胞,淋巴结转移组恶性黑色素瘤组织中的淋巴管数密度(LMVD)为9.845±2.454,无淋巴结转移组恶性黑色素瘤组织中的淋巴管数密度为6.534±2.193,淋巴结转移组恶性黑色素瘤组织内的淋巴管数密度明显高于无淋巴结转移组(P<0.01).结论恶性黑色素瘤组织内VEGF-C表达明显增高,并通过上调其受体VEGFR-3的表达促进恶性黑色素瘤组织内淋巴管的生成,从而促进恶性黑色素瘤的淋巴道转移.     

Expression of vascular endothelial growth factor-C and its receptor in invasive micropapillary carcinoma of the breast

Invasion to lymphatic vessels and metastasis to lymph nodes are frequent complications in invasive micropapillary carcinoma (IMPC) of human breast cancer. Vascular endothelial growth factor-C (VEGF-C) and its receptor, VEGFR-3 have been implicated as the important factors in the formation of lymphatic vessels and recent experimental evidence strongly suggests that lymphangiogenesis in tumor promotes lymphatic metastasis. To clarify the mechanism of its occurrence, the expression of VEGF-C, VEGFR-3 and lymphatic vessel density (LVD) was examined in 40 cases of IMPC (pure and mixed type) and in 40 cases of pseudo-IMPC. Cytoplasmic expression of VEGF-C and VEGFR-3 were more frequent in tumor cells of IMPC compared to those of pseudo-IMPC. A significant positive correlation was found between the expression of VEGF-C and VEGFR-3 in both IMPC and pseudo-IMPC. The expression of VEGF-C was also significantly associated with higher peritumoral LVD, lymphatic invasion and number of lymph node metastasis in IMPC. These findings suggest that VEGF-C promotes the proliferation of peritumoral lymphatic vessels and that lymphatic invasion and metastasis to lymph nodes are frequently induced in IMPC of breast.     

乳腺浸润性微乳头状癌的病理学特征与淋巴结转移的关系

目的研究乳腺浸润性微乳头状癌(IMPC)的病理学特征与淋巴结转移的关系。方法观察51例乳腺IMPC的主要病理学特征及淋巴结转移情况,采用免疫组织化学方法(LSAB法)检测IMPC中血管内皮生长因子(VEGF)-C和VEGF受体(R)-3的表达并计数淋巴管密度,分析其与淋巴结转移的关系。结果(1)乳腺IMPC病理组织学分级Ⅱ、Ⅲ级组的淋巴结转移数平均12.5个,明显高于Ⅰ级组的4.0个;(2)间质淋巴细胞浸润(+)和(++)组的淋巴结转移率(27/28,96.4%)明显高于(-)和(±)组(14/23,60.9%),且其淋巴结转移数平均14.4个,也明显高于(-)和(±)组的4.6个;(3)IMPC肿瘤细胞的VEGF-C表达在病理组织学分级Ⅱ、Ⅲ级组显著高于Ⅰ级组(P=0.03),VEGF-C的表达与淋巴结转移呈正相关(P=0.006);淋巴管密度与VEGF-C表达(P=0.009)、淋巴结转移(P=0.007)呈正相关;(4)肿瘤组织中IMPC成分的多少与淋巴结转移无显著性关系,淋巴结转移灶为纯IMPC或以IMPC成分为主;(5)28例伴有导管原位癌的IMPC中,14例为微乳头状型导管原位癌(14/28,50%)。结论乳腺IMPC的病理组织学分级、淋巴管密度及间质淋巴细胞浸润可能是影响IMPC淋巴结转移的关键性因素。VEGF-C和VEGFR-3表达增高是促使IMPC发生淋巴结转移的重要原因。微乳头状型导管原位癌可能是IMPC的早期阶段。     

血管内皮生长因子D的表达与乳腺癌淋巴管生成及淋巴结转移的相关性

目的 探讨乳腺癌患者不同区域淋巴管生成、淋巴管浸润特点以及与血管内皮生长因子D(VEGF-D)的表达关系,并结合腋淋巴结转移状态进行分析. 方法 选取乳腺癌根治术石蜡标本79例,分4个区域(肿瘤区、癌周区、近癌区、远癌区)取材.切片行免疫组织化学染色,采用D2-40对淋巴管进行标记,检测各区域淋巴管密度(LVD)、淋巴管浸润(LVI)及VEGF-D表达情况. 结果 癌周区LVD最高(20.25±2.03),肿瘤区VEGF-D和LVI阳性率最高,分别为87.34%和63.29%.肿瘤区VEGF-D表达与LVD之间、LVD与LVI之间、VEGF-D表达与LVI之间差异无统计学意义(P>0.05),但在其他各区域它们之间差异有统计学意义(P<0.05),且呈正相关.癌周区LVD与腋淋巴结转移状态有关(P<0.05);癌周区和近癌区的VEGF-D表达及LVI与腋淋巴结转移之间差异有统计学意义(P<0.05),但在其他区域差异无统计学意义(P>0.05). 结论 VEGF-D可能促进乳腺癌淋巴管生成,增加淋巴管浸润机会.LVD的增高易致淋巴管浸润,促进腋淋巴结转移.癌周区和近癌区在乳腺癌淋巴道转移以及评估腋淋巴结转移状态的研究中可能更具有意义.     

Prognostic significance of epidermal growth factor receptor and vascular endothelial growth factor receptor in colorectal adenocarcinoma

The purpose of this study was to evaluate the association between the expression of growth factors and the clinicopathological variables of colorectal adenocarcinoma. Immunohistochemistry and fluorescence in situ hybridization (FISH) were used to evaluate the amplification and expression of epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), VEGF-D, VEGF receptor (VEGFR)-2, VEGFR-3, transforming growth factor (TGF)-β1, and insulin-like growth factor-1 receptor (IGF-1R) in a tissue microarray of 292 colorectal adenocarcinomas. The expression of EGFR, VEGF, VEGF-D, VEGFR-2 and VEGFR-3 was detected in 5.1%, 10.0%, 6.8%, 5.2%, and 57.2%. EGFR expression was associated with angioinvasion (p < 0.05) and lymph node metastasis (p < 0.005). VEGFR-3 expression was higher in the rectum than in the colon (p < 0.05). VEGF expression correlated with VEGF-D (p < 0.05) and VEGFR-3 (p < 0.005) expression, while VEGF-D expression showed no significant association with VEGFR-2 or VEGFR-3. EGFR amplification was present in 10.6% and was not associated with EGFR protein expression. VEGFR-2 and VEGFR-3 expression levels were related to poor patient survival. Stage, perineural invasion, and lymph node metastasis were independent prognostic factors based on a Cox analysis. VEGFR-2 and VEGFR-3 expression are markers of a poor prognosis in patients with surgically resected colorectal adenocarcinoma, whereas EGFR has a minor influence.     

血管内皮生长因子-D、 微血管密度及微淋巴管密度的表达与乳腺癌临床病理特征的相关性

目的 探讨乳腺癌中血管内皮生长因子D(vascular endothelial growth factor-D,VEGF-D)及微血管密度(microvessel density,MVD)、微淋巴管密度(Lymphatic vessel density,MLD)表达情况及意义.方法 收集2009年1月至2016年5月在临沂市肿瘤医院病理科存档病例,其中乳腺癌61例,乳腺增生症23例.采用免疫组化法检测各组织VEGF-D、MVD和MLD表达.结果 乳腺癌组织中VEGF-D蛋白阳性率为62.30%,明显高于乳腺增生组织,差异有统计学意义(χ2=16.215,P<0.05);乳腺癌组织中MVD和MLD分别为(17.70±7.10)和(2.41±0.85),明显高于乳腺增生组织,差异有统计学意义(t=10.900、t=8.795,P<0.05);VEGF-D表达与乳腺癌患者年龄、肿瘤大小以及淋巴结转移无明显关系(χ2=0.394、0.032、0.244,P>0.05);MVD和MLD密度与乳腺癌患者年龄和肿瘤大小无明显差异(χ2=0.081,0.126,0.219,0.196,P>0.05);VEGF-D、MVD和MLD密度与乳腺癌组织学分级相关(χ2=13.076、23.892、10.082,P<0.05),随着组织学分级递增,VEGF-D、MVD和MLD密度明显增高;MVD和MLD在乳腺癌伴淋巴结转移中密度明显高于无淋巴结转移(t=2.481、5.791,P<0.05).结论 VEGF-D在乳腺癌组织中呈高表达,可能在乳腺癌的发生发展中起重要作用,而MVD和MLD与乳腺癌肿瘤分化、转移有一定的关系.     

食管癌血管内皮生长因子和受体的表达及在癌转移中的作用

目的观察人食管癌组织和淋巴管中血管内皮生长因子(VEGF-C)及其受体-3(VEGFR-3)的表达,探讨食管癌的淋巴道转移机制。方法取临床手术切除的食管癌组织,用免疫组化方法检测人食管癌早期和进展期癌细胞或淋巴管对VEGF-C及其VEGFR-3的表达情况。结果在食管癌的癌细胞中可见VEGF-C阳性表达,阳性颗粒主要定位于肿瘤细胞胞浆内。淋巴管内皮细胞仅见VEGFR-3阳性表达,VEGFR-3在血管和癌细胞中也存在少量阳性表达。进展期食管癌VEGF-C和VEGFR-3的表达率和表达强度均强于早期。结论食管癌癌细胞VEGF-C的表达和淋巴管内皮细胞上VEGFR-3的表达均与肿瘤进展呈正相关,推测VEGF-C通过受体VEGFR-3促进食管癌组织淋巴管生成,从而引起癌淋巴道转移。     

Tumor-associated macrophages express lymphatic endothelial growth factors and are related to peritumoral lymphangiogenesis

Formation of lymphatic metastasis is the initial step of generalized spreading of tumor cells and predicts poor clinical prognosis. Lymphatic vessels generally arise within the peritumoral stroma, although the lymphangiopoietic vascular endothelial growth factors (VEGF)-C and -D are produced by tumor cells. In a carefully selected collection of human cervical cancers (stage pT1b1) we demonstrate by quantitative immunohistochemistry and in situ hybridization that density of lymphatic microvessels is significantly increased in peritumoral stroma, and that a subset of stromal cells express large amounts of VEGF-C and VEGF-D. The density of cells producing these vascular growth factors correlates with peritumoral inflammatory stroma reaction, lymphatic microvessel density, and indirectly with peritumoral carcinomatous lymphangiosis and frequency of lymph node metastasis. The VEGF-C- and VEGF-D-producing stroma cells were identified in situ as a subset of activated tumor-associated macrophages (TAMs) by expression of a panel of macrophage-specific markers, including CD68, CD23, and CD14. These TAMs also expressed the VEGF-C- and VEGF-D-specific tyrosine kinase receptor VEGFR-3. As TAMs are derived from monocytes in the circulation, a search in peripheral blood for candidate precursors of VEGFR-3-expressing TAMs revealed a subfraction of CD14-positive, VEGFR-3-expressing monocytes, that, however, failed to express VEGF-C and VEGF-D. Only after in vitro incubation with tumor necrosis factor-alpha, lipopolysaccharide, or VEGF-D did these monocytes start to synthesize VEGF-C de novo. In conclusion VEGF-C-expressing TAMs play a novel role in peritumoral lymphangiogenesis and subsequent dissemination in human cancer.     

人喉癌组织中VEGF-C、VEGF-D及其受体3的表达及意义

目的 探讨喉癌组织中VEGF—C、D和受体VEGFR-3的表达及其在喉癌进展中的作用。方法 取人喉癌标本12例,正常及良性病变喉组织10例,免疫组化法观察VEGF—C、VEGF—D、VEGFR-3以及LYVE-1的表达。结果 VEGF—C和VEGF—D主要表达于喉癌细胞胞浆内,喉癌组织中VEGF—C和VEGF—D表达的阳性率明显高于正常及良性病变喉组织（P〈0．05）;VEGFR-3主要表达于基底层的癌细胞,在喉癌组织中VEGFR-3表达的阳性率明显高于正常和良性病变组织中（P〈0．01）,并且VEGFR-3的表达与VEGF—C、VEGF—D的表达显著正相关（P〈0．01）。LYVE—1仅见表达于淋巴管内皮细胞。结论 喉癌组织中VEGF—C、VEGP-D的表达明显增高,推测可能通过与VEGFR-3的结合促进喉癌组织中淋巴管的生成;LYVE-1是淋巴管内皮细胞较特异的标记物。     

血管内皮生长因子C、D和受体3在人胰腺癌组织中的表达

目的:通过观察不同临床指标的人胰腺癌组织VEGF-C、VEGF-D、VEGFR-3的表达,来探讨VEGF-C和VEGF-D对人胰腺癌转移的影响,为癌组织中淋巴管的生成机制以及癌的淋巴道转移机制提供理论依据。方法:取人胰腺癌标本33例及癌旁正常胰腺组织15例,用免疫组化的方法观察VEGF-C、VEGF-D及VEGFR-3在人胰腺癌和癌旁正常胰腺组织中的表达。结果:VEGF-C、VEGF-D和VEGFR-3在胰腺癌组织中的表达比例较在癌旁正常胰腺组织中的表达比例明显增高,并且VEGFR-3的表达与VEGF-D的表达具有显著相关性(P<0.01),与VEGF-C的表达不具有相关性(P>0.05)。胰腺癌组织中VEGF-C和VEGF-D的表达与患者的年龄、性别、远处转移无关(P>0.05)。结论:VEGF-C、VEGF-D在胰腺癌组织中的表达明显增高,并有可能通过与VEGFR-3的结合促进了癌组织中淋巴管的生成,从而对癌的淋巴道转移起促进作用。     

VEGF和D2-40在食管鳞癌中的表达及其临床意义

目的观察血管内皮生长因子(VEGF)和D2-40在人食管鳞癌组织内的表达,探讨VEGF的表达与食管鳞癌组织淋巴管密度(LVD)及淋巴结转移之间的关系。方法将67例食管鳞状细胞癌分为有淋巴结转移和无淋巴结转移两组,免疫组化法检测食管鳞癌组织中VEGF和D2-40的表达,并与正常组进行对照。结果 VEGF蛋白主要表达于癌细胞胞浆内,D2-40表达于癌组织内淋巴管内皮细胞,在食管鳞癌的癌组织中VEGF的阳性表达率和D2-40阳性淋巴管密度均高于正常食管组织(P0.05),且有淋巴结转移组的阳性表达率高于无淋巴结转移组(P0.05)。结论 VEGF的高表达可能与食管鳞癌的淋巴管生成和淋巴道转移密切相关。     

Signaling for lymphangiogenesis via VEGFR-3 is required for the early events of metastasis

Metastasis to regional lymph nodes is an important and early event in many tumors. Vascular endothelial growth factor-C (VEGF-C), VEGF-D and their receptor VEGFR-3, play a role in tumor spread via the lymphatics, although the timing of their involvement is not understood. In contrast, VEGFR-2, activated by VEGF-A, VEGF-C and VEGF-D, is a mediator of angiogenesis and drives primary tumor growth. We demonstrate the critical role for VEGFR-3, but not VEGFR-2, in the early events of metastasis. In a tumor model exhibiting both VEGF-D-dependent angiogenesis and lymphangiogenesis, an antibody to VEGFR-2 (DC101) was capable of inhibiting angiogenesis (79 % reduction in PECAM + blood vessels) and growth (93 % reduction in tumor volume). However, unlike an anti-VEGFR-3 Mab (mF4-31C1), DC101 was not capable of eliminating either tumor lymphangiogenesis or lymphogenous metastasis (60 % reduction of lymph node metastasis by DC101 vs 95 % by mF4-31C1). Early excision of the primary tumors demonstrated that VEGF-D-mediated tumor spread precedes angiogenesis-induced growth. Small but highly metastatic primary human breast cancers had significantly higher lymphatic vessel density (23.1 vessels/mm²) than size-matched (11.7) or larger non-metastatic tumors (12.4) thus supporting the importance of lymphatic vessels, as opposed to angiogenesis-mediated primary tumor growth, for nodal metastasis. These results suggest that lymphangiogenesis via VEGF-D is more critical than angiogenesis for nodal metastasis.     

血管内皮生长因子C及其受体在MNNG诱发的大鼠大肠癌细胞及淋巴管的表达

目的 观察大鼠大肠癌组织内血管内皮生长因子-C(VEGF-C)及其受体3(VEGFR-3)的表达情况,探讨VEGF-C及其受体VEGFR-3在肿瘤淋巴转移中的作用.方法 采用甲基硝基亚硝基胍(MNNG)诱发的大鼠大肠癌模型,应用免疫组织化学(SABC法)技术检测29例大鼠原发性大肠癌组织中VEGF-C及VEGFR-3蛋白,观察VEGF-C及VEGFR-3在大肠癌组织内的表达.结果 正常大肠组织内未见VEGF-C阳性表达,但可见淋巴管内皮细胞VEGFR-3阳性表达.在大肠癌组织内,VEGF-C蛋白表达于癌细胞,早期和中晚期癌的阳性表达率分别是75%和100%,(P＜0.05).VEGFR-3主要表达于淋巴管内皮细胞,早期和中晚期癌组织内淋巴管的阳性表达率分别是58.33%和94.12%(P＜0.05).结论 大鼠大肠癌VEGF-C的表达与肿瘤进展有关,推测VEGF-C通过受体VEGFR-3诱导淋巴管生成:VEGFR-3在淋巴管的阳性表达均随肿瘤进展增高,可能与大肠癌淋巴转移有关.     

血管内皮生长因子D在卵巢上皮癌组织内的表达与淋巴结转移的关系

目的观察血管内皮生长因子D(vascular endothelial growth factor D,VEGF-D)在卵巢上皮癌组织内的表达,探讨VEGF-D在卵巢癌淋巴管生成中的作用及其与淋巴结转移的关系。方法取人卵巢上皮癌组织78例,免疫组化法观察VEGF-D在卵巢上皮癌组织内的表达情况。以淋巴管内皮特异性标记物D2-40标记淋巴管,计数癌组织内淋巴管数密度。结果VEGF-D蛋白主要表达于卵巢癌细胞胞浆内,在淋巴结转移组卵巢癌组织内的表达水平明显高于无淋巴结转移组(P<0.01)。淋巴结转移组卵巢癌组织内的淋巴管数密度明显高于无淋巴结转移组(P<0.01)。结论VEGF-D表达与卵巢癌淋巴管数密度及淋巴结转移之间具有显著的相关性。     

VEGFR-3 expression in breast cancer tissue is not restricted to lymphatic vessels

We examined the immunohistochemical reactivity for vascular endothelial growth factor receptor 3 (VEGFR-3), a protein playing an important role in lymphangiogenesis, in breast cancer. A retrospective series of 77 invasive ductal breast carcinomas was investigated. The relationship between VEGFR-3 expression and clinicopathologic parameters was examined for statistical significance using Pearson's chi-square (chi2) test and Fisher's exact test (when n<5). Threshold for significance was p<0.05. Patient age ranged from 31 to 77 years (mean: 55 years). The VEGFR-3 immunoreactivity was as follows: 5 cases were negative (6.5%), 35 + (45.4%), 27+ + (35.1%), and 10+ + + (13.0%). Reactions were positive for both lymphatic and blood vessels in several cases. VEGFR-3-positive reactions were more frequent in the tumor periphery than within the tumor. Immunoreactivity was also observed in myoepithelial cells surrounding both normal ducts and ducts with ductal carcinoma in situ. Statistical analysis of VEGFR-3 reactions was not significantly related to node status, microvessel density, and tumor grade. Ploidy showed a tendency towards significance (p=0.063); however, owing to the limited number of cases, statistical significance was not reached. VEGFR-3 lacks lymphatic vessel specificity and is also expressed in blood vessels, myoepithelial cells, and neoplastic cells.     

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

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.