Abstract
The quantification of angiogenic and linfangiogenic factors has been explored in an attempt to predict the prognosis of various malignancies. In gastric cancer (GC), a promising parameter is the microvessel density (MVD). Objective: The aim of our study is to evaluate the different methods used for its quantification. Methods: 52 cases of GC were labeled by immunohistochemistry for CD34, CD105 and D2-40. The quantification of the microvasculature was performed for each marker by counting microvessels (mv) in three “hot spots”, using three different microscopic magnifications (100x, 200x and 400x). MVD was then calculated by dividing the number of vessels by the microscopic field area (measured in mm2) and compared between the three different evaluations. Results: the MVD obtained for CD34 was 203 mv/mm2 (100x), 311 mv/mm2 (200x) and 490 mv/mm2 (400x). The MVD score for CD105 was 127 mv/mm2 (100x), 213 mv/mm2 (200x) and 347 mv/mm2 (400x). The MVD obtained for D2-40 was 35 mv/mm2 (100x), 69 mv/mm2 (200x) and 170 mv/mm2 (400x). We found that MVD obtained in 100x magnification was lower than 200x, which was lower than in 400x. Those differences were statistically significant and occurred in a proportional way for all three markers. MVD obtained for CD34 was higher than for CD105. The MVD for lymphatics obtained by D2-40 was lower than the MVD for CD34 and CD105. Conclusion: Our results show that the lack of standardized methods for assessing angiogenesis and lymphangiogenesis in GC can produce variations in the MDV value, impairing the reproducibility of the results and the comparison between different studies and populations. It is necessary to standardize the MVD determination methods to compare results and confirm its prognostic value in GC and in other types of tumors.
Highlights
Current research on neoplastic diseases focus on revealing new indicators capable of predicting the biological behavior of tumors and the prognosis of patients in the early stages of the disease
Our results show that the lack of standardized methods for assessing angiogenesis and lymphangiogenesis in gastric cancer (GC) can produce variations in the MDV value, impairing the reproducibility of the results and the comparison between different studies and populations
The mean microvessel density (MVD) obtained for CD34 was 203 microvessels/mm2 (100x), 311 microvessels/mm2 (200x) and 490 microvessels/mm2 (400x)
Summary
Current research on neoplastic diseases focus on revealing new indicators capable of predicting the biological behavior of tumors and the prognosis of patients in the early stages of the disease. The study of angiogenic and lymphangiogenic factors has been explored in an attempt to predict the prognosis of various types of cancers [15]. From the pathological point of view, it is expected that the mechanisms responsible for the relationship between the tumor and local endothelial cells are active in those highly vascularized areas, called hot spots. These areas presumably arise due to the existence of angiogenic tumor cell clone, which is more likely to enter the bloodstream and result in metastases [9]. A promising parameter in gastric cancer (GC) is the microvessel density (MVD), both lymphatic and blood vessel [12,13]
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