Abstract
BackgroundThe 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;MethodsEndometrial 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;ResultsOur 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;ConclusionsP-LVD may serve as a prognostic factor for endometrial carcinoma. The peritumoral lymphatics might play an important role in lymphatic vessel metastasis.
Highlights
The lymphatic system is a major route for cancer cell dissemination and a potential target for antitumor therapy
Forty-seven (46.1%) patients were diagnosed in Federation of Gynecology and Obstetrics (FIGO) stage I and twenty-six (25.5%) patients were diagnosed in FIGO stage II, whereas 29 (28.4%) were diagnosed in FIGO stage III
Pelvic and/or para-aortic lymph node sampling was performed for 59 patients (57.8%) and 27 of these (26.5%) had lymph node metastasis
Summary
The lymphatic system is a major route for cancer cell dissemination and 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. Since dissemination through lymphatic vessels is the main means of tumor spread, we hypothesized that lymphatic vessel density (LVD) might serve as Lymphangiogenesis has been difficult to study because of the lack of specific lymphatic markers. This situation has changed with the discovery of lymphangiogenic markers, such as VEGF-C, VEGF-D, VEGFR-3, LYVE-1, PROX1, and podoplanin. Little is known about the role of LYVE-1 in lymphatic metastasis
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