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Type of vascular invasion in association with progress of endometrial cancer
Author(s) -
Visser Nicole C.M.,
Werner Henrica M.J.,
Krakstad Camilla,
Mauland Karen K.,
Trovik Jone,
Massuger Leon F.A.G.,
Nagtegaal Iris D.,
Pijnenborg Johanna M.A.,
Salvesen Helga B.,
Bulten Johan,
Stefansson Ingunn M.
Publication year - 2017
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/apm.12774
Subject(s) - medicine , endometrial cancer , lymphadenectomy , immunohistochemistry , lymph node , lymph , lymphatic system , metastasis , cancer , oncology , lymphatic vessel , pathology
Vascular invasion ( VI ) is a well‐established marker for lymph node metastasis and outcome in endometrial cancer. Our study explored whether specific types of VI , defined as lymphatic ( LVI ) or blood vessel invasion ( BVI ), predict pattern of metastasis. From a prospectively collected cohort, we conducted a case–control study by selecting three groups of endometrial cancer patients (n = 183): 52 with positive lymph nodes at primary surgery, 33 with negative nodes at primary surgery and later recurrence and death from disease, and 98 with negative nodes and no recurrence. All patients underwent hysterectomy with lymphadenectomy. Immunohistochemical staining with D2‐40 and CD 31 antibodies was used to differentiate between BVI and LVI . By immunohistochemical staining, detection of VI increased from 24.6 to 36.1% of the cases. LVSI was significantly more often seen in patients with positive lymph nodes compared with patients with negative nodes (p = 0.001). BVI was significantly more often seen in node‐negative patients with recurrence compared with node‐negative patients without recurrence (p = 0.011). In multivariable analysis, BVI , age, and tumor grade were predictors separating patients with and without recurrence. Lymph node–positive patients showed more often LVI compared with lymph node–negative patients, while BVI seems to be a predictor for recurrent disease.