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Lymphatic vessel invasion detected by the endothelial lymphatic marker D2-40 (podoplanin) is predictive of regional lymph node status and an independent prognostic factor in patients with resected esophageal cancer | Kozłowski | Folia Histochemica et Cytobiologica

Lymphatic vessel invasion detected by the endothelial lymphatic marker D2-40 (podoplanin) is predictive of regional lymph node status and an independent prognostic factor in patients with resected esophageal cancer

Mirosław Kozłowski, Wojciech Naumnik, Jacek Nikliński, Robert Milewski, Grzegorz Łapuć, Jerzy Laudański

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Abstract

The discovery of markers to lymphatic endothelial cells and the development of novel antibodies to
these markers have brought increasing attention to the lymphatics and progress in the understanding of lymphangiogenesis
and cancer metastasis. In this study, we investigate the presence of lymphatic vessel invasion
(LVI) detected by D2-40 immunohistochemical staining in resected esophageal cancer and correlated with
clinicopathologic data and patient survival. Sixty nine patients, who had a primary resection of esophageal
cancer, were analyzed by univariate and multivariate logistic regression, and univariate and multivariate survival
analysis. The total rate of LVI was 72% (50/69). Positive LVI was significantly correlated with lymph node
metastasis (p < 0.001), tumor size (p < 0.001), histological grading (p = 0.017), tumor depth (p = 0.001), and
stage (p < 0.001). Multivariate logistic analysis identified LVI (p = 0.036) as a predictor of regional lymph
node metastasis. On univariate survival analysis, patients with LVI had a significantly shorter disease-free
survival, cancer-specific survival and overall survival. Multivariate analysis proved that LVI diagnosed by D2-40
is an independent prognostic factor of both disease-free survival (p = 0.04) and overall survival (p = 0.032) in
resected esophageal cancer. These results show that LVI assessment identifies patients at high risk for regional
lymph node metastasis and that LVI is an independent prognostic factor in patients with esophageal cancer.
(Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 1, pp. 90–97)

Keywords

esophageal cancer; lymphatic vessel invasion; podoplanin; D2-40; lymph node metastasis; prognosis

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