OBJECTIVETo investigate the evaluation of lymphatic emboli by D2-40/CKpan dual immunostain and its prognostic significance in advanced primary gastric adenocarcinoma.

METHODSTissue samples of 108 cases of advanced gastric adenocarcinoma with radical gastrectomy were collected from Chinese PLA General Hospital in 2001. Lymphatic emboli were evaluated by D2-40/CKpan dual immunostain on consecutive sections, and compared with routine HE staining. The correlation of lymphatic emboli with lymph node metastasis and overall survival was analyzed by Pearson Chi-squared test and univariate survival analysis, respectively.

RESULTSLymphatic emboli were detected in 73/108 (67.6%) cases by D2-40/CKpan staining, compared to 57/108 (52.8%) by HE staining. There was significant difference (P=0.007). Lymphatic emboli on HE staining revealed false negative in 24/108 cases and false positive in 8/108 cases. A significant correlation was found between lymphatic emboli and lymph node metastasis on HE staining (P=0.024), while it was not found on D2-40/CKpan staining (P=0.422). The overall survival rate was significantly different between lymphatic emboli positive and negative cases on HE staining (P=0.043). The overall survival rate was lower in lymphatic emboli positive cases on HE staining. Lymphatic emboli evaluated on D2-40/CKpan staining had no prognostic value (P=0.402).

CONCLUSIOND2-40/Ckpan dual immunostaining is more sensitive for lymphatic emboli in gastric adenocarcinoma but may not predict lymph node metastasis and survival, while HE staining may.

Gastrectomy ; Humans ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Prognosis ; Stomach Neoplasms ; pathology

OBJECTIVE: Establishment of transplanted model of VX2 supraglottic carcinoma in rabbits and investigation the rule of lymphatic vessels formation. METHOD: After establishment of VX2 tumor-bearing rabbits, the carcinoma tissues were transplanted into the operculum laryngis submucosa in sixty New-Zealand white rabbits to establish transplanted tumor model. Vascular endothelial growth factor-3 (VEGFR-3) label staining was performed to observe lymphatic vessels. Number density, volume density of lymphatics periphery region of carcinoma, normal region and centre region were measured using computer image analysis system. RESULT: There was no lymphatic vessels in carcinomatous centre region,but the lymphatic vessels number density, volume density in periphery region was much more than normal region. Their cavities were dilated. The discrepancy had statistical significance (P<0.01). CONCLUSION The rule of lymphatic formation in rabbit VX2 supraglottic carcinoma model mimesis rule of lymphatic formation anthropo- supraglottic carcinoma. Lymphatic multiplication and dilation at periphery region of carcinoma is associated with lymph node metastasis. Evaluation of it at periphery region of carcinoma may be useful in predicting lymph node metastasis in patients with supraglottic carcinoma. This conclusion provides theoretical basis for utility of the anti-tumor medicines which inhibit lymphatic formation in animal model.
Animals ; Cell Line, Tumor ; Humans ; Laryngeal Neoplasms ; pathology ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Neoplasm Transplantation ; Rabbits

OBJECTIVETo evaluate the value of routine haematoxylin-eosin(HE) stain for submucosal lymphatic vessel infiltration in early gastric cancer.

METHODSFour thousand four hundred and twenty early gastric cancer patients underwent D2 operation. Submucosal lymphatic vessel was detected by routine HE stain. The results were compared with pathological lymph node metastasis.

RESULTSIn early gastric cancer, the sensitivity, specificity, accuracy, positive predicting value (PPV), and negative predicting value (NPV) of routine HE stain for submucosal lymphatic vessel infiltration were 54.5%, 82.0%, 78.9%, 27.4%, and 93.5% respectively. In early gastric cancer limited in mucosa, these indexes were 14.5%, 98.0%, 95.8%, 15.8%, and 97.8% respectively. In early gastric cancer infiltrated to submucosa, they were 60.3%, 57.8%, 58.3%, 28.1%, and 84.2% respectively. There were significant differences of submucosal lymphatic vessel infiltration with lymph node metastasis (P< 0.001), but no significant difference with survival rate. The 5-year survival rates of submucosal lymphatic vessel infiltration positive and negative group were 84.4% and 87.3%, median survival time was 6998 d and 7237 d, and mean survival time was 6163.9 d and 6042.6 d respectively (P=0.2495).

CONCLUSIONThe accuracy of routine HE stain is too low, thus it is not suitable for diagnosing submucosal lymphatic vessel infiltration in early gastric cancer.

Adenocarcinoma ; pathology ; Female ; Gastric Mucosa ; pathology ; Humans ; Lymphatic Metastasis ; pathology ; Lymphatic Vessels ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Predictive Value of Tests ; Sensitivity and Specificity ; Staining and Labeling ; Stomach Neoplasms ; pathology

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; Lymphatic Metastasis ; pathology ; Lymphatic Vessels ; pathology ; Male ; Middle Aged ; Neck ; pathology ; Neoplasm Staging

OBJECTIVETo investigate the status of lymph node metastases (LNM) of esophageal carcinoma and to identify the risk factors.

METHODSClinical data of 308 patients who underwent esophagectomy with three-field lymphadenectomy during January 2006 and December 2010 were reviewed. Characteristics of LNM were studied.

RESULTSThe average number of dissected lymph nodes was 35.6 ± 14.5 in 308 patients. There were 197 patients(64%) had LNM. Logistic regression analysis showed that lymphatic vessel invasion(P=0.019) and deep tumor invasion(P<0.001) were risk factors of LNM. The highest LNM site was paratracheal node(25.0%). The incidence of cervical LNM was 14.1% in the middle thoracic carcinoma, higher than that of upper thoracic (7.3%) and lower thoracic (8.3%). Rate of LNM was lower in upper thoracic carcinomas than that in middle or lower ones(P=0.001). No significant difference of LNM was found among upper, middle and lower thoracic carcinoma for cervical or thoracic nodes. Lymphatic vessel invasion(P<0.001) and metastases in paratracheal lymph nodes (P=0.014) were risk factors for cervical LNM.

CONCLUSIONSLNM of esophageal carcinoma can be found in both directions vertically and skipped metastasis. Paratracheal lymph nodes involvement is an indicator for cervical lymphadenectomy in thoracic esophageal carcinoma.

Aged ; Carcinoma, Squamous Cell ; pathology ; Esophageal Neoplasms ; pathology ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Lymphatic Vessels ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

OBJECTIVE: To analyze the correlated factors of cervical lymphatic metastasis of T3 and T4 glottic carcinoma. METHOD: We did a retrospective analysis of 91 glottic carcinoma patients' clinical data to analyze cervical lymph node metastasis on different T stage, pathologic degree and the tumor sites. RESULT: The cervical lymph node metastasis rate of 91 cases of T3 and T4 glottic carcinoma was 21.98%. T3 group's metastasis rate was 18.06% (13/72), T4 group's metastasis rate was 36.84% (7/19), P > 0.05. Grouped according to the degree of pathological differentiation, well-differentiated squamous cell carcinoma metastasis rate is 13.89% (5/36), middle-differentiated squamous cell carcinoma metastasis rate is 26.00% (13/50), and poorly-differentiated squamous cell carcinoma metastasis rate is 40.00% (2/5), P > 0.05. Cervical lymph node metastasis rate was 16.22%, when the tumor invading supraglottic region. Cervical lymph node metastasis rate was 15.38%, when the tumor invading subraglottic region. Cervical lymph node metastasis rate was 46.15%, when the tumor invading supraglottic and subraglottic region (P < 0.01). CONCLUSION Cervical lymph node metastasis in cN0 patient with supraglottic carcinoma is effected by T classification, cervical lymphatic metastasis of T3 and T4 glottic carcinoma is not entirely effected by T stage and pathologic degree. When the tumor invades supraglottic and subraglottic region, cervical lymph node metastasis is significantly higher. Therefore, the area of tumor invasion is an important factor for lymph node metastasis.
Humans ; Laryngeal Neoplasms ; pathology ; Lymph Nodes ; Lymphatic Metastasis ; Lymphatic Vessels ; Neck ; Neck Dissection ; Neoplasm Staging ; Retrospective Studies

OBJECTIVETo investigate the expression of Podoplanin in lesional epithelia of oral leukoplakia and squamous cell carcinoma and its correlation with lymph vessels density.

METHODSThe expression of Podoplanin in 40 cases of oral leukoplakia, 27 cases of early stage of squamous cell carcinoma and 32 cases of infiltrated stage of squamous cell carcinoma was examined by immunohistochemistry. Meanwhile, the correlation between podoplanin expression in lesional epithelia and its corresponding lymph vessels density was also analysed.

RESULTSPodoplanin expression in epithelia was increased with the exacerbated epithelial proliferation. High expression of Podoplanin in lesional epithelia accounted for 45% in oral leukoplakia, 81% and 78% in early and infiltrated stage of squamous cell carcinoma respectively. Moreover, the lymph vessels density was also increased with the enhanced expression of Podoplanin in oral leukoplakia and early stage of squamous cell carcinoma (P < 0.05). Podoplanin expression in infiltrated stage of squamous cell carcinoma was positively correlated with the lymph vessels density (P < 0.05).

CONCLUSIONSPodoplanin expression in different proliferative oral epithelia may be related to oral carcinogenesis, invasion and metastasis.

Aged ; Biomarkers ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Leukoplakia, Oral ; metabolism ; pathology ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Membrane Glycoproteins ; metabolism ; Mouth Neoplasms ; metabolism ; pathology

OBJECTIVETo investigate the feasibility of D2-40 labeling for detecting lymphatic vessels in breast cancer tissues and the clinicopathological implications of lymphatic vessel invasion (LVI).

METHODSImmunohistochemistry was used to detect the expression of D2-40 and lymphatic invasion in 72 cases of breast cancer and 15 benign breast tumor tissues, and their correlations to the clinicopathological factors were analyzed.

RESULTSThe positivity rate of LVI was 69.4% in breast cancer tissue. In patients with lymph node metastasis, the positivity rate of LVI was significantly higher than that in patients without lymph node involvement (85.7% vs 54.1%, P<0.01), and LVI was found to be positively correlated to axillary lymph node metastasis (r=0.382).

CONCLUSIOND2-40 can specially and reliably mark the lymphatic vessels in breast cancer tissues. LVI is positively correlated to axillary lymph node metastasis and occurs earlier than the latter, therefore should be included in routine clinicopathological testing.

Adult ; Aged ; Antibodies, Monoclonal ; Breast Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Immunohistochemistry ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; pathology ; Lymphatic Vessels ; pathology ; Middle Aged ; Neoplasm Staging

OBJECTIVETo clarify the clinicopathological significance of lymphatic vessel density (LVD) and distribution in pancreatic cancer.

METHODSWe measured LVD in 43 pancreatic cancer specimens by immunostaining with specific lymphatic endothelium marker, and examined their relationship with well-defined clinicopathological variables.

RESULTSIntratumoral LVD (9.4 +/- 10.0) was significantly lower than periturmoral (16.0 +/- 9.7) (P < 0.001) and nontumoral LVD (13.5 +/- 6.0) (P < 0.01). Increased peritumoral LVD correlated significantly with tumor staging (P < 0.05) and lymph node involvement (P < 0.05).

CONCLUSIONThe lymphatic vessels distribution in pancreatic cancer samples and peritumoral lymphangiogenesis may promote the malignant progression and lymph node metastasis of pancreatic cancer.

Adenocarcinoma ; pathology ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunohistochemistry ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Male ; Middle Aged ; Pancreatic Neoplasms ; pathology

OBJECTIVETo evaluate anatomical and functional images of contrast MR lymphangiography in the diagnosis of limb lymphatic circulation disorders.

METHODS30 patients with limb lymphedema were enrolled in the study. There were 27 patients of primary lymphedema and 3 of secondary lymphedema. Contrast enhanced lymphangiography was performed with 3.0 T MR Unit after intracutaneous injection of gadobenate dimeglumine into the interdigital webs of the dorsal foot and hand. The kinetics of enhanced lymph flow within the lymphatics were calculated using the formula: Speed (cm) = total length of visualized lymph vessel (cm)/ inspection time (minutes) and by comparing dynamic nodal enhancement and time-signal intensity curves between edematous and contralateral limbs. Morphological abnormalities of the lymphatic system were also evaluated.

RESULTSFollowing injection of the contrast agent enhanced lymphatic channels were consistently visualized in all clinical lymphedematous limbs and five contralateral limbs of unilateral lymphedema cases. The speed of enhanced flow within the lymphatics of lymphedematous limbs ranged from 0.30 to 1.48 cm/min. The contrast enhancement in inguinal nodes of edematous limbs was significantly lower than that of contralateral limbs (P < 0.01). Dynamic measurement of contrast enhancement showed a remarkable lowering of peak time (P < 0.01) and peak enhancement (P < 0.01) and a delay in outflow in inguinal nodes of affected limbs compared with that of control limbs. Post-contrast MR imaging also depicted varied distribution patterns of lymphatics and abnormal lymph flow pathways within lymph nodes in the limbs with lymphatic circulation disorders.

CONCLUSIONSContrast MR lymphangiography with gadobenate dimeglumine was able to visualize the precise anatomy of lymphatic vessels and lymph nodes in lymphedematous limbs. It also provided comprehensive information about the functional status of lymph flow transportation in lymphatics and lymph nodes.

Adolescent ; Adult ; Child ; Humans ; Lymph Nodes ; pathology ; Lymphatic Vessels ; pathology ; Lymphedema ; diagnostic imaging ; pathology ; Lymphography ; methods ; Middle Aged ; Young Adult