Abstract
BackgroundLymphatic vessel density and lymphovascular invasion are commonly assessed to identify the clinicopathological outcomes in breast cancer. However, the prognostic values of them on patients’ survival are still uncertain.MethodsDatabases of PubMed, Embase, and Web of Science were searched from inception up to 30 June 2016. The hazard ratio with its 95% confidence interval was used to determine the prognostic effects of lymphatic vessel density and lymphovascular invasion on disease-free survival and overall survival in breast cancer.ResultsNineteen studies, involving 4215 participants, were included in this study. With the combination of the results of lymphatic vessel density, the pooled hazard ratios and 95% confidence intervals were 2.02 (1.69–2.40) for disease-free survival and 2.88 (2.07–4.01) for overall survival, respectively. For lymphovascular invasion study, the pooled hazard ratios and 95% confidence intervals were 1.81 (1.57–2.08) for disease-free survival and 1.64 (1.43–1.87) for overall survival, respectively. In addition, 29.56% (827/2798) of participants presented with lymphovascular invasion in total.ConclusionsOur study demonstrates that lymphatic vessel density and lymphovascular invasion can predict poor prognosis in breast cancer. Standardized assessments of lymphatic vessel density and lymphovascular invasion are needed.
Highlights
Lymphatic vessel density and lymphovascular invasion are commonly assessed to identify the clinicopathological outcomes in breast cancer
We evaluated the impacts of lymphatic vessel density, lymphovascular invasion on survival by pooling the hazard ratio (HR) results
Lymphovascular invasion was defined as the presence of tumor emboli within a lymphatic vessel lumen, which was detected by immunohistochemical staining rather than hematoxylin and eosin (H&E) staining
Summary
Lymphatic vessel density and lymphovascular invasion are commonly assessed to identify the clinicopathological outcomes in breast cancer. Several independent risk factors for survival have been identified, including tumor size, histological grade, nodal status, hormone receptor status, and HER-2 status [2, 3]. These risk factors are insufficient to fully determine an individual’s prognosis. Lymphatic vessel was formerly considered as a passive participant in tumor metastasis and regarded mainly as a transportation channel for tumor cells. It appears that lymphatic vessel provides a safe route for tumor
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