Open AccessAnalysis of tumor‐induced lymphangiogenesis and lymphatic vessel invasion of pancreatic carcinoma in the peripheral nerve plexus
Author(s) -
Cheng Peng,
Jin Gang,
Hu Xiangui,
Shi Min,
Zhang Yijie,
Liu Rui,
Zhou Yingqi,
Shao Chenghao,
Zheng Jianming,
Zhu Minghua
Publication year - 2012
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/j.1349-7006.2012.02364.x
Subject(s) - lymphangiogenesis , lymphatic system , pathology , lymphatic vessel , medicine , lymphovascular invasion , metastasis , pancreatic cancer , vascular endothelial growth factor c , lymph node , immunohistochemistry , cancer , vascular endothelial growth factor , vascular endothelial growth factor a , vegf receptors
Cancer cells can metastasize throughout the body by various mechanisms, including the lymphatic system, resulting in tumor‐induced lymphangiogenesis that can profoundly affect patient survival. The aim of the present study was to examine the role of lymphangiogenesis in the metastasis of pancreatic cancer to the peripheral nerve plexus. Immunohistochemistry was performed to analyze specimens obtained from 70 ductal adenocarcinoma patients. The markers used included lymphangiogenic factor vascular endothelial growth factor ( VEGF )‐ C , the lymphatic‐specific marker D 2‐40, and cytokeratin 19, an independent prognostic factor for pancreatic tumors. The relationship between survival rate and invasion of both the lymphatic vessels and peripancreatic nerve plexus ( PNP ) was evaluated, with clearly elevated lymphatic vessel density ( LVD ) in tissues adjacent to the cancer tissues. In fact, LVD levels were higher in adjacent tissues than in localized cancer tissues, and lymphatic vessel invasion into tissues adjacent to the tumor was significantly correlated with both PNP invasion ( P = 0.005) and lymph node metastasis ( P = 0.010). Correspondingly, LVD in tissues adjacent to the tumor was correlated with both invasion of lymphatic vessels surrounding the tumor ( P = 0.024) and VEGF ‐ C expression ( P = 0.031); in addition, VEGF ‐ C expression was correlated with invasion of lymphatic vessels around the tumor ( P = 0.004). Survival rates were significantly lower in patients in whom there was peritumor lymphatic vessel invasion ( P < 0.001), extrapancreatic nerve plexus invasion ( P = 0.001), and/or lymph node metastasis ( P < 0.001). Based on these results, lymphatic invasion associated with adjacent tumor growth likely contributes to the development of metastatic tumors that invade the PNP .