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Prognostic Significance of Immunohistochemically Detected Blood and Lymphatic Vessel Invasion in Colorectal Carcinoma: Its Impact on Prognosis

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Abstract

Background

The prognostic significance of blood vessel invasion (BVI) and lymphatic vessel invasion (LVI) is unclear. Because of the absence of specific markers for venous and lymphatic vessels, earlier studies could not reliably distinguish between BVI and LVI.

Methods

By immunostaining for podoplanin and CD34 antigen, we retrospectively investigated LVI and BVI in 419 tissue specimens of colorectal carcinoma. We performed univariate and multivariate analysis of the clinicopathologic features, frequency of recurrence, and outcome of patients with or without LVI and BVI.

Results

The use of hematoxylin and eosin (H&E) staining to identify BVI and LVI yielded a false positive rate of 9.1% and false negative rate of 12.6%. The incidence of BVI was significantly higher among tumors with LVI than tumors without LVI (P <.001). In logistic multivariate analysis, only LVI (P < .001) was associated with lymph node metastasis and BVI (P = .015) was associated with distant recurrence. Calculating the prognostic relevance, both two invasion types correlated with decreased survival in univariate analysis (both P <.001). In multivariate analysis, BVI (P =.024), lymph node status (P =.003) and tumor stage (P <.001) remained statistically significant factors for survival.

Conclusions

Our results suggest that immunohistologic evaluation of BVI and LVI could be useful in colorectal carcinoma indicating the risk of lymph node metastasis and recurrence, thereby contributing to prognostic evaluation.

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Acknowledgments

The authors thank Tsutomu Kohda for technical assistance and are grateful to Prof. J. Patrick Barron of the International Medical Communications Center of Tokyo Medical University for his review of this manuscript. This work was supported by the Tokyo Medical University Cancer Foundation (200409).

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Authors and Affiliations

  1. Fourth Department of Surgery, Tokyo Medical University Kasumigaura Hospital, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan

    Pin Liang MD, Ichiro Nakada MD, Takanobu Tabuchi MD, Gyo Motohashi MD, Akira Takemura MD, Takeshi Nakachi MD, Teruhiko Kasuga MD & Takafumi Tabuchi MD

  2. Department of General Surgery, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China

    Pin Liang MD

  3. Department of Pathology, Tokyo Medical University Kasumigaura Hospital, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan

    Jian-Wei Hong MD

  4. Fourth Department of Surgery, Tokyo Medical University Kasumigaura Hospital, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan

    Pin Liang MD

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  1. Pin Liang MD
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  2. Ichiro Nakada MD
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Correspondence to Pin Liang MD.

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Liang, P., Nakada, I., Hong, JW. et al. Prognostic Significance of Immunohistochemically Detected Blood and Lymphatic Vessel Invasion in Colorectal Carcinoma: Its Impact on Prognosis. Ann Surg Oncol 14, 470–477 (2007). https://doi.org/10.1245/s10434-006-9189-3

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  • DOI: https://doi.org/10.1245/s10434-006-9189-3

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