Lympho-Vascular Invasion by Detecting D2-40 Was the Potent Prognostic Predictor in Breast Cancer Patients.

Abstract

Abstract (Introduction) Distant metastasis and recurrence are the major factors of prognosis in breast cancer patients. Both of lymphovascular invasion (LVI) and blood vascular invasion (BVI) are known to be the important route for metastasis to regional lymph nodes and systemic metastasis. Despite the importance of vascular invasion as a prognostic factor, the application of vascular invasion as a histopathologic criterion is controversial. The aims of this study were to distinguish between LVI and BVI for the role of prognosis and recurrence in breast cancer patients by using an endothelial subtype specific immunohitochemical stain (podoplanin, D2-40 and CD31)Methods) Sections from 80 paraffin-embedded archival specimens of invasive breast cancer were stained for expression of podoplanin, D2-40, and CD31. The results of immunohistochemical staining were correlated with clinicopathologic features, such as tumor size, the status of lymph node metastases, estrogen receptor status, progesterone receptor status and HER2 expression, and recurrence. The patients with ductal carcinoma in situ and stage 4 breast cancer were excluded.Results) A significant correlation was found in the higher expression of D2-40, and lymph node metastasis. (P=0.02) We found a significant correlation between the expression of D2-40 and the recurrence of breast cancer. (P=0.04) However, there was no significant correlation between BVI and recurrence. A poorer disease free survival was shown in the higher expression of D2-40. (P<0.01) In multivariate analysis, the higher expression of D2-40 revealed a significant association with decreased disease-free survival.Conclusion) The higher expression of D2-40 was the more prognostic predictor than blood vascular invasion in breast cancer patients. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6171.