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Grading system of lymphatic invasion according to D2‐40 immunostaining is useful for the prediction of nodal metastasis in squamous cell carcinoma of the uterine cervix
Author(s) -
Urabe A,
Matsumoto T,
Kimura M,
Sonoue H,
Kinoshita K
Publication year - 2006
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2006.02536.x
Subject(s) - immunostaining , lymphatic system , grading (engineering) , pathology , medicine , cervix , metastasis , lymphovascular invasion , lymph node , immunohistochemistry , cancer , biology , ecology
Aims To determine the relationship between lymphatic invasion detected by D2‐40 immunostaining and nodal metastasis in squamous cell carcinoma (SCC) of the cervix. Methods and results Seventy‐five cases of FIGO stage IB to IIB SCC of the cervix, treated by radical hysterectomy and lymph node dissection, were examined. Immunohistochemistry for D2‐40 was performed. Overestimation of lymphatic invasion on conventional histological examination was demonstrated by assessment of D2‐40 immunoreactivity in 22 cases. A significant difference in lymphatic invasion detected by D2‐40 immunostaining was found between the metastatic group (30 cases) and the non‐metastatic group (45 cases) ( P < 0.001). A grading system (grade 0–2) of lymphatic invasion according to D2‐40 immunostaining was devised. Subsequently, the frequency of nodal metastasis significantly increased in accordance with the grade of lymphatic invasion ( P < 0.001) and in eight cases with grade 2, seven cases (87.5%) had nodal metastasis. Conclusions In cervical SCC, a grading system for lymphatic invasion according to D2‐40 immunostaining is useful for the prediction of nodal metastasis and grade 2 lymphatic invasion is a strong predictor of nodal metastasis.