Clinical Significance of Tumor Cell-lined Vessel in Colorectal Cancer: Correlation with Tissue-Infiltrated Macrophage and Hypoxia Inducible Factor-1alpha Expression

Abstract

Purpose. Recent studies had suggested tumor cell-lined vessel may involve in cancer progression. Our aim was to study the role of tumor cell-lined vessel (TCLV) in colorectal cancer (CRC) and the association of TCLV with tissue-infiltrated macrophage (TIM) and hypoxia inducible factor-1 alpha (HIF-1α) expression. Methods. Immunohistochemical staining in 58 patients with CRC were evaluated. Double-stain of CD34 and pan-cytokeratin was used to identify TCLV which are lack of endothelium lining. Hypoxia was evaluated by examining HIF-1α expression in tumor cells. Monoclonal antibodies of CD68 were used to investigate the TIM. Their correlations with clinicopathologic features were analyzed with chi-square test. Results. TCLVs were identified in 17/58 (29.3%) of tumor samples. Presence of TCLV correlated significantly with T stage (P=0.001) and histologic differentiation (P=0.038). In cancer tissues, the mean TIM (cells/mm^2) was 143±49. There was significant correlation between TIM and T stage (P=0.016), lymph node state (P=0.034), and tumor metastasis (P=0.002). Significant association between HIF-1α expression and presence of TCVL was also noted (P=0.004). Conclusion. This study showed that cancer microenvironment could change tumor cells to a more aggressive behavior. The presence of TCVL, TIM, and HIF-1α expression are potentially useful markers of tumor progression in CRC.