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Reevaluation of lymphovascular invasion in gastric cancer using endothelial markers D2‐40 and EVG: Enhanced detection, better predictor of lymph node metastasis and biological aggressiveness
Author(s) -
Liu Jingdong,
Li Haojie,
Zhou Peng,
Cai Tianyi,
Tang Zhaoqing,
Wang Yan,
Cui Yuehong,
Sun Yihong,
Wang Xuefei
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26468
Subject(s) - lymphovascular invasion , medicine , perineural invasion , immunohistochemistry , h&e stain , stage (stratigraphy) , cancer , pathology , lymph node , metastasis , oncology , gastroenterology , biology , paleontology
Background and Objectives The diagnosis of lymphovascular invasion (LVI) is often inaccurate with routine histology. This study aimed to evaluate the use of immunohistochemistry (IHC) in detecting LVI and reevaluate the clinical implications of LVI in gastric cancer. Methods This prospective unrandomized cohort study analyzed the rates of LVI positivity and its relevance with other clinicopathologic features. Results Between November 2017 and April 2018, 558 patients undergoing curative gastrectomy were enrolled and assigned to the IHC group ( n = 285) and hematoxylin–eosin group ( n = 273). The use of IHC increased the rates of LVI positivity (60.8% vs. 43.3%, p < .001) and decreased the rates of undetermined LVI subtype (7.7% vs. 27.1%, p < .001). The LVI‐negative patients identified by IHC had fewer lymph node metastases (16.8% vs. 34.6%, p = .002) and earlier pathological stage ( p = .004) than those identified by routine histology. The LVI‐positive patients identified by IHC had a higher percentage of perineural invasion ( p = .019). Conclusions The use of endothelial markers significantly enhanced the detection of LVI. The LVI detected by IHC could be a better predictor of lymph node metastasis and biological aggressiveness in gastric cancer.