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Lymphatic spread in squamous cell carcinoma of the penis is independent of elevated lymph vessel density
Author(s) -
Naumann Carsten Maik,
AlNajar Amr,
Alkatout Ibrahim,
Hegele Axel,
Korda Joanna Beate,
Bolenz Christian,
Kalthoff Holger,
Sipos Bence,
Juenemann KlausPeter,
Van Der Horst Christof
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.08365.x
Subject(s) - lymphatic system , lymphatic vessel , lymphangiogenesis , pathology , medicine , lymph , lymph node , carcinoma , metastasis , lymphatic endothelium , penis , cancer , anatomy
OBJECTIVE To examine the potential effect of tumour‐induced lymphangiogenesis in squamous cell carcinoma of the penis as a possible mechanism responsible for lymphatic spread. PATIENTS AND METHODS Specimens from 65 patients with invasive tumours (31 with and 34 without metastases) were evaluated for lymphatic vessel density (LVD) by the ‘hot‐spot’ method as the density of lymphatic endothelium hyaluronan receptor (LYVE‐1)‐positive lymphatic vessels per unit area of tissue. LVD was examined in peritumoral, intratumoral and normal tissue areas. The LVD of each tumour in these locations was calculated as the mean of the three highest lymph vessel counts in three to five hot‐spots. The nodal status was based on histopathological examination or an uneventful follow‐up of ≥2 years. RESULTS In all patients the mean ( sd ) peritumoral LVD of 8.05 (3.14)/0.75 mm 2 was significantly higher than for intratumoral and normal tissue, of 4.67 (2.58) and 5.20 (1.87), respectively ( P < 0.001). The slightly lower intratumoral LVD than in normal tissue was not significant. The peritumoral LVD was 8.07 (3.29) in metastatic and 8.03 (3.03) in non‐metastatic carcinomas. The intratumoral LVD was 5.13 (3.01) in node‐positive carcinomas and 4.28 (2.15) in tumours with no lymphatic node metastasis (LNM). Comparing tumours with and without LNM, there was no statistically significant difference between intra‐ and peritumoral LVD. CONCLUSION Increased LVD does not significantly affect the lymphatic spread in penile carcinomas, indicating that there must be alternative mechanisms that selectively enable tumour cells to invade lymph vessels and to metastasize into the lymph nodes.