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Park KJ, Selinger CI, Alvarado-Cabrero I, Duggan MA, Kiyokawa T, Mills AM, Ordi J, Otis CN, Plante M, Stolnicu S, Talia KL, Wiredu EK, Lax SF, McCluggage WG. Dataset for the Reporting of Carcinoma of the Cervix: Recommendations From the International Collaboration on Cancer Reporting (ICCR). Int J Gynecol Pathol 2022; 41:S64-S89. [PMID: 36305535 DOI: 10.1097/pgp.0000000000000909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cervical carcinoma remains one of the most common cancers affecting women worldwide, despite effective screening programs being implemented in many countries for several decades. The International Collaboration on Cancer Reporting (ICCR) dataset for cervical carcinoma was first developed in 2017 with the aim of developing evidence-based standardized, consistent and comprehensive surgical pathology reports for resection specimens. This 4th edition update to the ICCR dataset on cervical cancer was undertaken to incorporate major changes based upon the updated International Federation of Obstetricians and Gynecologists (FIGO) staging for carcinoma of the cervix published in 2018 and the 5th Edition World Health Organization (WHO) Classification of Female Genital Tumors published in 2020 and other significant developments in pathologic aspects of cervical cancer. This updated dataset was developed by a panel of expert gynecological pathologists and an expert gynecological oncologist, with a period of open consultation. The revised dataset includes "core" and "noncore" elements to be reported; these are accompanied by detailed explanatory notes and references providing the rationale for the updates. Standardized reporting using datasets such as this helps facilitate consistency and accuracy, data collection across different sites and comparison of epidemiological and pathologic parameters for quality and research purposes.
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Sato D, Kadota T, Inaba A, Nishihara K, Takashima K, Nakajo K, Sawada K, Kotani D, Fujiwara H, Yoda Y, Kojima T, Fujita T, Fujii S, Yano T. Long-term clinical outcome after endoscopic resection of esophageal squamous cell carcinoma invading the muscularis mucosae without lymphovascular invasion. Gastrointest Endosc 2022; 95:634-641.e3. [PMID: 34774578 DOI: 10.1016/j.gie.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/02/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Lymph node recurrence (LNR) after endoscopic resection (ER) in patients with esophageal squamous cell carcinoma (ESCC) pathologically invading the muscularis mucosae (pMM) without lymphovascular invasion (LVI) has been reported as non-negligible in the ER guidelines for esophageal cancer by the Japan Gastroenterological Endoscopy Society. However, these data were not regarded as high-level evidence because several retrospective case series were tabulated without sufficient long-term follow-up. Hence, this guideline stated that the administration of additional treatment after ER could not be determined for this population. This study aimed to clarify the long-term clinical outcomes after ER of pMM ESCC without LVI. METHODS Between January 2009 and November 2017, we enrolled followed patients who underwent ER and were diagnosed with pMM ESCC without LVI with no additional treatments. We retrospectively investigated the cumulative recurrence rate and recurrence-free, overall, and disease-specific survival at 5 years after ER. RESULTS Eighty-seven patients were enrolled. During the median follow-up period of 64 months (range, 12-117), 3 patients developed lymph node and/or distant recurrence, and 2 of these cases occurred more than 3 years after ER; all 3 patients died of the primary disease. The 5-year cumulative recurrence rate was 4.3%, and the 5-year recurrence-free, disease-specific, and overall survival rates were 88.8%, 98.2%, and 91.7%, respectively. CONCLUSIONS The long-term outcome for patients with pMM ESCC without LVI was favorable after ER; however, this population had a risk of recurrence directly leading to death. Long-term follow-up is necessary, with attention to the timing of recurrence.
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Affiliation(s)
- Daiki Sato
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan; Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - Tomohiro Kadota
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Atsushi Inaba
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Keiichiro Nishihara
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kenji Takashima
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Keiichiro Nakajo
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kentaro Sawada
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Daisuke Kotani
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hisashi Fujiwara
- Department of Esophageal Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yusuke Yoda
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeo Fujita
- Department of Esophageal Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Satoshi Fujii
- Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan; Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
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Gülseren D, Gököz Ö, Karahan S, Karaduman A. Podoplanin expression in cutaneous squamous cell carcinomas and its relationship to histopathological prognostic factors. J Histotechnol 2020; 43:147-152. [PMID: 32496961 DOI: 10.1080/01478885.2020.1757872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
There are several clinicopathological factors associated with the prognosis of cutaneous squamous cell carcinomas (cSCC), but there remains a lack of molecular markers associated with cSCC tumor progression. This study aimed to determine the association between histopathological prognostic parameters and tumoral podoplanin expression in cSCC. This study included 63 paraffin embedded cSCC samples that were evaluated for tumoral podoplanin expression using immunohistochemistry. Among the 63 tumor samples, 27% lacked podoplanin expression, 22% exhibited diffuse podoplanin expression, and 51% exhibited focal podoplanin expression. Tumoral podoplanin expression was correlated with lymphovascular invasion and lymph node metastasis (p value < 0.05, for both). Additional research is needed to further delineate how the tumoral podoplanin expression can be used as a prognostic marker in patients with cSCC.
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Affiliation(s)
- Duygu Gülseren
- Department of Dermatology, School of Medicine, Hacettepe University , Ankara, Turkey
| | - Özay Gököz
- Department of Pathology, School of Medicine, Hacettepe University , Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, School of Medicine, Hacettepe University , Ankara, Turkey
| | - Ayşen Karaduman
- Department of Dermatology, School of Medicine, Hacettepe University , Ankara, Turkey
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Hiroshima Y, Zhang Y, Zhang N, Maawy A, Mii S, Yamamoto M, Uehara F, Miwa S, Yano S, Murakami T, Momiyama M, Chishima T, Tanaka K, Ichikawa Y, Bouvet M, Murata T, Endo I, Hoffman RM. Establishment of a patient-derived orthotopic Xenograft (PDOX) model of HER-2-positive cervical cancer expressing the clinical metastatic pattern. PLoS One 2015; 10:e0117417. [PMID: 25689852 PMCID: PMC4331082 DOI: 10.1371/journal.pone.0117417] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 12/22/2014] [Indexed: 01/14/2023] Open
Abstract
Squamous cell carcinoma of the cervix, highly prevalent in the developing world, is often metastatic and treatment resistant with no standard treatment protocol. Our laboratory pioneered the patient-derived orthotopic xenograft (PDOX) nude mouse model with the technique of surgical orthotopic implantation (SOI). Unlike subcutaneous transplant patient-derived xenograft (PDX) models, PDOX models metastasize. Most importantly, the metastasis pattern correlates to the patient. In the present report, we describe the development of a PDOX model of HER-2-positive cervical cancer. Metastasis after SOI in nude mice included peritoneal dissemination, liver metastasis, lung metastasis as well as lymph node metastasis reflecting the metastatic pattern in the donor patient. Metastasis was detected in 4 of 6 nude mice with primary tumors. Primary tumors and metastases in the nude mice had histological structures similar to the original tumor and were stained by an anti-HER-2 antibody in the same pattern as the patient's cancer. The metastatic pattern, histology and HER-2 tumor expression of the patient were thus preserved in the PDOX model. In contrast, subcutaneous transplantation of the patient's cervical tumors resulted in primary growth but not metastasis.
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Affiliation(s)
- Yukihiko Hiroshima
- AntiCancer, Inc., San Diego, CA, United States of America
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yong Zhang
- AntiCancer, Inc., San Diego, CA, United States of America
| | - Nan Zhang
- AntiCancer, Inc., San Diego, CA, United States of America
| | - Ali Maawy
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
| | - Sumiyuki Mii
- AntiCancer, Inc., San Diego, CA, United States of America
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
| | - Mako Yamamoto
- AntiCancer, Inc., San Diego, CA, United States of America
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
| | - Fuminari Uehara
- AntiCancer, Inc., San Diego, CA, United States of America
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
| | - Shinji Miwa
- AntiCancer, Inc., San Diego, CA, United States of America
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
| | - Shuya Yano
- AntiCancer, Inc., San Diego, CA, United States of America
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
| | - Takashi Murakami
- AntiCancer, Inc., San Diego, CA, United States of America
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masashi Momiyama
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takashi Chishima
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kuniya Tanaka
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasushi Ichikawa
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Michael Bouvet
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
| | - Takuya Murata
- Department of Obstetrics and Gynecology, Kawasaki University Medical School, Kawasaki, Japan
| | - Itaru Endo
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Robert M. Hoffman
- AntiCancer, Inc., San Diego, CA, United States of America
- Department of Surgery, University of California San Diego, San Diego, CA, United States of America
- * E-mail:
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Shimizu K, Funai K, Sugimura H, Sekihara K, Kawase A, Shiiya N. D2-40-positive lymphatic vessel invasion is not a poor prognostic factor in stage I lung adenocarcinoma. Pathol Int 2013; 63:201-5. [PMID: 23692420 DOI: 10.1111/pin.12048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 03/21/2013] [Indexed: 11/29/2022]
Abstract
The present study investigates whether lymphatic vessel invasion (LVI) detected by D2-40 staining is a prognostic factor for stage I adenocarcinoma of the lung. We retrospectively reviewed 124 patients who underwent complete resection for stage I adenocarcinoma of the lung from January 1983 to June 2003. LVI was microscopically evaluated using D2-40 immunostaining. The median follow-up was 71 months. The LVI positive rate was 37%. The 5-year cancer-specific survival rates of the D2-40 positive LVI and negative groups were 88.8% and 84.3%, respectively (P = 0.630). The stage I lung adenocarcinoma patients who were determined to be LVI positive based on D2-40 immunostaining did not have a significantly poorer prognosis than the LVI negative cases. Thus, lymphatic microinvasion may not be a prognostic indicator in early lung cancer, although advanced LVI does appear to correlate with survival. It is therefore unnecessary to use D2-40 immunostaining to diagnose LVI in practical settings, and Hematoxylin-Eosin and Elastica van Gieson staining should continue to be used to predict the prognosis of patients with stage I lung adenocarcinoma.
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Affiliation(s)
- Kei Shimizu
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Li C, Fan J, Song X, Zhang B, Chen Y, Li C, Mi K, Ma H, Song Y, Tao X, Li G. Expression of angiopoietin-2 and vascular endothelial growth factor receptor-3 correlates with lymphangiogenesis and angiogenesis and affects survival of oral squamous cell carcinoma. PLoS One 2013; 8:e75388. [PMID: 24040410 PMCID: PMC3770542 DOI: 10.1371/journal.pone.0075388] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 08/15/2013] [Indexed: 12/03/2022] Open
Abstract
Background Both Ang-2 and VEGFR-3 are major regulators of angiogenesis and lymphangiogenesis, respectively, and thus may affect prognosis of OSCC. We sought to determine the associations between Ang-2 and VEGFR-3 expression and survival of OSCC. Methods Ang-2 and VEGFR-3 expression was determined immunohistochemically in tumor tissues from 112 patients with OSCC; OSCC-adjacent noncancerous oral tissue from 85 OSCC patients; and normal oral mucosa from 37 cancer-free individuals. A log-rank test and Cox proportional hazard models were used to compare survival among different groups with expression of Ang-2 and VEGFR-3. Results Ang-2 and VEGFR-3 expression was upregulated in OSCC compared to nontumor tissue (all P<0.05). High Ang-2 expression positively correlated with microvessel density (MVD) (P<0.01), and high VEGFR-3 expression positively correlated with lymph node metastasis (P<0.01) and lymphatic vessel density (LVD) (P<0.01). The patients with high expression of Ang-2 alone or in combination with VEGFR-3 had a significantly worse survival than in patients with low expression of Ang-2 or any other co-expression status (all P<0.05), respectively. Furthermore, multivariable analysis showed that patients with high expression of Ang-2 alone or in combination with VEGFR-3 had a significantly increased risk of death compared with those with low expression of Ang-2 or any other co-expression status (HR, 2.7, 95% CI, 1.1–6.2 and 5.0, 1.3–15.4, respectively). Conclusions These results suggest that increased expression in tumors of Ang-2 may individually, or in combination with VEGFR-3, predict poor prognosis of OSCC.
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Affiliation(s)
- Chao Li
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Chengdu, China
- State Key Laboratory of Oral Diseases in Sichuan University, Sichuan, China
| | - Jinchuan Fan
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Chengdu, China
| | - Xicheng Song
- Department of Otorhinolaryngology Head and Neck Surgery, Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Bing Zhang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Chengdu, China
| | - Yu Chen
- State Key Laboratory of Oral Diseases in Sichuan University, Sichuan, China
| | - Chunhua Li
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Chengdu, China
| | - Kun Mi
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Chengdu, China
| | - Hong Ma
- Department of Oral and Maxillary Surgery, the Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Yufeng Song
- Department of Oral and Maxillary Surgery, the Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Xiaofeng Tao
- Radiology Department of Shanghai Ninth People's Hospital Affiliated Shanghai JIaoTong University School of Medicine, Shanghai, China
- * E-mail: (GJL); cjr.taoxiaofeng.@vip.163.com (XFT)
| | - Guojun Li
- Department of Head and Neck Surgery, U.T. M.D. Anderson Cancer Center, Houston, Texas, United States of America
- * E-mail: (GJL); cjr.taoxiaofeng.@vip.163.com (XFT)
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9
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Xiong Y, Cao LP, Rao HL, Cai MY, Liang LZ, Liu JH. Clinical significance of peritumoral lymphatic vessel density and lymphatic vessel invasion detected by D2-40 immunostaining in FIGO Ib1-IIa squamous cell cervical cancer. Cell Tissue Res 2012; 348:515-22. [PMID: 22492093 DOI: 10.1007/s00441-012-1384-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 02/23/2012] [Indexed: 11/28/2022]
Abstract
The clinical significance of lymphangiogenesis in cervical cancer remains controversial. Our aim was to investigate the correlation between lymphangiogenesis, lymphatic vessel invasion (LVI) and tumor metastasis, invasion and prognosis in squamous cell cervical cancer. Paraffin sections of 90 patients with FIGO (Fédération Internationale de Gynécologie et d'Obstétrique) Ib1-IIa squamous cell cervical cancer were stained for immunohistochemistry with a D2-40 monoclonal antibody against the carcinoembryonic antigen M2A. The lymphatic vessel density (LVD) and LVI were measured, and their relationship with the clinicopathological data was analyzed. D2-40-positive lymphatic vessels were found in 75 of the 90 patients (83.3 %). All D2-40-positive vessels were located in peritumoral areas. The mean±SD of the peritumoral LVD was 10.08±4.16. The positive rate of LVI was 32.0 % (24/75). The recurrence rate of patients with LVD >10 (62.1 %, 18/29) was significantly higher than that of patients with LVD ≤10 (34.8 %, 16/46, P = 0.021). The 5-year recurrence-free survival rate of patients with LVD >10 (41.0 %) was significantly lower than that of patients with LVD ≤10 (67.0 %, P = 0.045). Univariate analysis showed that the peritumoral LVD (≤10 vs >10) was correlated with LVI (absent vs present, P = 0.016). The peritumoral LVD and LVI showed no correlation with age, FIGO stage, tumor size, tumor grade, depth of invasion, or pelvic lymph node metastasis (all: P > 0.05). Peritumoral lymphangiogenesis was correlated with the recurrence and recurrence-free survival in patients with squamous cell cervical cancer. Examination of peritumoral LVD in these patients might therefore help to estimate the risk of recurrence.
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Affiliation(s)
- Ying Xiong
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, People's Republic of China
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Prognostic Significance of Tumor-Associated Lymphangiogenesis in Malignant Melanomas of the Conjunctiva. Ophthalmology 2011; 118:2351-60. [DOI: 10.1016/j.ophtha.2011.05.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 05/17/2011] [Accepted: 05/18/2011] [Indexed: 01/09/2023] Open
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Cimpean AM, Mazuru V, Cernii A, Ceausu R, Saptefrati L, Cebanu A, Fit AM, Raica M. Detection of early lymphangiogenesis by lymphatic microvascular density and endothelial proliferation status in preneoplastic and neoplastic lesions of the uterine cervix. Pathol Int 2011; 61:395-400. [DOI: 10.1111/j.1440-1827.2011.02673.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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12
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Recent Developments in Defining Microinvasive and Early Invasive Carcinoma of the Uterine Cervix. J Low Genit Tract Dis 2011; 15:146-57. [DOI: 10.1097/lgt.0b013e3181fb425d] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Lymphatic vessel density as a prognostic marker in clinical stage I endocervical adenocarcinoma. Int J Gynecol Pathol 2010; 29:386-93. [PMID: 20567154 DOI: 10.1097/pgp.0b013e3181c3cd47] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
There are limited data evaluating the significance of lymphatic vessel density (LVD) as a prognostic marker in cervical adenocarcinoma. In this study, we investigated intratumoral and peritumoral LVD, using the lymphatic marker D2-40, as a prognostic marker in endocervical adenocarcinoma. Surgical specimens from 50 consecutive patients with endocervical adenocarcinoma treated with complete staging surgical procedures were reviewed. Selected tumor blocks were immunostained for D2-40 and CD31. Positively stained microvessels (MVs) were counted in densely vascular/lymphatic foci (hot spots) at 400x field in each specimen (0.17 mm). Results were expressed as the highest MV count identified within any single field. Both intratumoral CD31 MV and peritumoral D2-40 LVD showed significant correlation with depth of invasion (r=0.39, 0.37, respectively), percentage of circumferential involvement (r=0.36, 0.48, respectively), and lymphovascular invasion detected by D2-40 (r=0.45, 0.51, respectively; P<0.01). Only peritumoral D2-40 LVD showed a significant correlation with lymph node metastases (r=0.40; P<0.01), disease-free and overall survivals. Using univariate analysis, peritumoral D2-40 LVD showed significant correlation with lymphovascular invasion detected by D20-40 and lymph node metastases (P<0.05), which was maintained on multivariate analysis. D2-40 detected lymphovascular invasion in 16 of 50 (32%) cases, and showed a significant correlation with depth of invasion, lymph node metastases, involvement of parametrium (r=0.41, 0.38, 0.32, respectively; P<0.01), and disease-free survival. Our study showed that both angiogenesis and lymphangiogenesis play an important role in the progression of endocervical adenocarcinoma, and that peritumoral D2-40 LVD is an independent predictor of lymph node metastasis.
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Zaganelli FL, Carvalho FM, Almeida BG, Bacchi CE, Goes JCS, Calil MA, Baracat EC, Carvalho JP. Intratumoral Lymphatic Vessel Density and Clinicopathologic Features of Patients With Early-Stage Cervical Cancer After Radical Hysterectomy. Int J Gynecol Cancer 2010; 20:1225-31. [DOI: 10.1111/igc.0b013e3181ead337] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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15
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Prognostic significance of peritumoral lymphatic vessel density and vascular endothelial growth factor receptor 3 in invasive squamous cell cervical cancer. Transl Oncol 2010; 3:170-5. [PMID: 20563258 DOI: 10.1593/tlo.09292] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 12/14/2009] [Accepted: 12/15/2009] [Indexed: 11/18/2022] Open
Abstract
Cervical cancer is known to metastasize primarily by the lymphatic system. Dissemination through lymphatic vessels represents an early step in regional tumor progression, and the presence of lymphatic metastasis is associated with a poor prognosis. In patients who have undergone a radical hysterectomy, lymphovascular space invasion (LVSI), assessed on hematoxylin and eosin-stained slides, is a major factor for adjuvant therapy in patients with cervical cancer. With the advent of a lymphatic endothelial cell-specific marker, such as D2-40, it is now possible to distinguish between blood and lymphatic space invasion (LSI). In this study, the utility of D2-40 was assessed for the detection of lymphatic vessel density (LVD) and identification of LSI. The expressions of vascular endothelial growth factor receptor-3 (VEGFR-3), VEGF-C, tyrosine receptor kinase-2, and angiopoietin-1 were assessed by immunohistochemical methods on 50 patients with squamous cell carcinoma of the cervix. Clinicopathologic characteristics, including pelvic lymph node metastasis, were correlated with the above histochemical findings. We found that lymphangiogenesis, measured by an increase in peritumoral LVD, was significantly associated with positive lymph node status (P < .005). VEGFR-3 expression was significantly associated with LVD (P < .05). D2-40 staining verified LSI (P = .03) and surpassed that of hematoxylin and eosin-identified LVSI (P = .54). In conclusion, lymphangiogenic markers, specifically LVD quantified by D2-40 and VEGFR-3, are independently associated with LSI and lymph node metastasis in patients with early squamous cell carcinoma of the cervix treated with radical hysterectomy and pelvic lymphadenectomy.
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Heindl LM, Hofmann-Rummelt C, Adler W, Holbach LM, Naumann GO, Kruse FE, Cursiefen C. Tumor-Associated Lymphangiogenesis in the Development of Conjunctival Squamous Cell Carcinoma. Ophthalmology 2010; 117:649-58. [DOI: 10.1016/j.ophtha.2010.01.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 11/23/2009] [Accepted: 01/15/2010] [Indexed: 10/19/2022] Open
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17
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Wangsa D, Heselmeyer-Haddad K, Ried P, Eriksson E, Schäffer AA, Morrison LE, Luo J, Auer G, Munck-Wikland E, Ried T, Lundqvist EA. Fluorescence in situ hybridization markers for prediction of cervical lymph node metastases. THE AMERICAN JOURNAL OF PATHOLOGY 2009; 175:2637-45. [PMID: 19893027 PMCID: PMC2789632 DOI: 10.2353/ajpath.2009.090289] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/21/2009] [Indexed: 02/06/2023]
Abstract
The presence of lymph node metastases is associated with poor prognosis in early stage cervical cancer. As of yet, no molecular markers predicting lymph node metastases have been identified. We examined single genetic markers and a composite marker, comprised of three fluorescence in situ hybridization (FISH) probes targeting the genes LAMP3, PROX1, and PRKAA1, in pretreatment cervical biopsies from 16 lymph node positive cases and 15 lymph node negative controls from women with stage IB and IIA cervical cancer. In addition, we determined clonal patterns by including CCND1 to compare the clonal constitution of primary tumors and associated lymph node metastases. The composite FISH marker allowed for classification of patients into those with and without lymph node metastases with a sensitivity and specificity of 75% and 87%, respectively (P = 0.001). The positive predictive value and negative predictive value were 86% and 76%, respectively. Clonal patterns varied among the tumors. In many cases, changes between the primary tumor and lymph node metastases in the most common clones may indicate that certain clones have a growth advantage for establishing metastases in lymph nodes. We conclude that the composite FISH marker may be useful for determining risk for subsequent development of lymph node metastases in patients with cervical cancer.
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Affiliation(s)
- Darawalee Wangsa
- Department of Oncology-Pathology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
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Park KJ, Soslow RA. Current concepts in cervical pathology. Arch Pathol Lab Med 2009; 133:729-38. [PMID: 19415947 DOI: 10.5858/133.5.729] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2008] [Indexed: 11/06/2022]
Abstract
CONTEXT The correct diagnosis and reporting of cervical in situ and invasive carcinoma are essential for the appropriate clinical management of patients with human papillomavirus-associated disease. OBJECTIVES To review common mistakes made in the diagnosis of cervical dysplasia and invasive carcinoma, describe variants and benign mimics of high-grade squamous intraepithelial lesion and adenocarcinoma in situ, and discuss available ancillary studies that can be useful in making the distinctions as well as to review important factors related to prognosis that should be included in the pathology report. DATA SOURCES Review of current literature. CONCLUSIONS There are many mimics and variants of cervical squamous and glandular lesions that can be resolved with ancillary studies and careful histologic examination. Prognostically important features, such as tumor size, presence of vascular invasion, and margin status, should always be included in the pathology report.
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Affiliation(s)
- Kay J Park
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
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Völker HU, Scheich M, Nowack I, Metzger A, Haubitz I, Puppe B, Hagen R, Müller-Hermelink HK, Völter C. Lymphangiosis carcinomatosa in squamous cell carcinomas of larynx and hypopharynx--value of conventional evaluation and additional immunohistochemical staining of D2-40. World J Surg Oncol 2009; 7:25. [PMID: 19261178 PMCID: PMC2653073 DOI: 10.1186/1477-7819-7-25] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Accepted: 03/04/2009] [Indexed: 11/10/2022] Open
Abstract
Background Recent studies revealed a predictive value of lymphatic vessel invasion (L1) for the nodal metastasizing and poor prognosis in malignant tumors at different sites. The monoclonal antibody D2-40 (podoplanin) stains specifically endothelial cells of lymphatic vessels and improves the search for L1. However, the importance of this immunohistochemical staining was not investigated in squamous cell carcinomas (SCC) of larynx and hypopharynx. Aim This study was performed to compare the diagnostic potential of convential and immunohistochemical determination of L1 in SCC of larynx and hypopharynx with special respect to the predictive value for nodal metastasizing and prognosis. Methods 119 SCCs of the larynx (n = 70) respectively hypopharynx (n = 49) were investigated. The lymphatic vessel invasion was assessed by conventional method (HE stain) and immunohistochemical staining with an antibody against D2-40 (DAKO, Germany). Immunohistochemistry was performed in accordance with manufacturer's protocol. L1 was searched microscopically in a standardized magnification (×200) in serial sections of tumor samples (1 section per cm tumor diameter). Results The immunohistochemical investigation did not show significant advantages for the prediction of regional nodal metastases. Despite a low sensitivity (< 50%) in both methods, the specifity can reach 80%. The negative predictive value in both methods seems acceptable (up to 80%), whereas the positive predictive value is not higher than 64%. Cases with L1 detected either conventionally or immunohistochemically did not show a significant shorter survival than cases with L0. However, a non-significant shorter survival was found. Only in SCC of hypopharynx, a combination of both methods revealed patients with a significant worse prognosis. Conclusion The status of lymphatic vessel invasion should be documented in standardized tumor reports. A benefit of an additional immunohistochemical investigation was not found, for the daily routine HE-stain seems sufficient.
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Doekhie FS, Morreau H, de Bock GH, Speetjens FM, Dekker-Ensink NG, Putter H, van de Velde CJH, Tollenaar RAEM, Kuppen PJK. Sialyl Lewis X expression and lymphatic microvessel density in primary tumors of node-negative colorectal cancer patients predict disease recurrence. CANCER MICROENVIRONMENT 2008; 1:141-51. [PMID: 19308692 PMCID: PMC2654349 DOI: 10.1007/s12307-008-0014-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Accepted: 07/17/2008] [Indexed: 01/30/2023]
Abstract
Up to 30% of curatively resected colorectal cancer patients with tumor-negative lymph nodes, show disease recurrence. We assessed whether these high-risk patients can be identified by examining primary tumors for the following blood and lymphatic vasculature markers: A) sialyl Lewis X (sLeX), vascular endothelial growth factor (VEGF)-C and VEGF-D expression; B) blood and lymphatic microvessel density (BMVD/LMVD); and C) the presence of blood and lymphatic vessel invasion. Thirty-six cases (disease recurrence within 5 years) and 72 controls (no disease recurrence for at least 5 years) were selected in a case-control design. Tumor sections were stained by antibodies CSLEX1 (sLeX), anti-VEGF-C, anti-VEGF-D, anti-CD31 (BMVD) or D2–40 (LMVD) to determine the parameters as mentioned above. A multivariate analysis showed sLeX expression and high LMVD (odds ratio 5.1, 95% confidence interval 1.3–20.0 and odds ratio 3.1, 95% confidence interval 1.0–10.0, respectively) to be independent factors predicting disease recurrence. Expression of sLeX correlated with liver metastases (P = 0.015). A high LMVD was related to regional intra-abdominal or intrapelvic metastases in lymph nodes and distant metastases other than in the liver and lungs such as peritoneum, bones, brain and adrenal glands (P = 0.004). A high BMVD in the invasive front correlated with lung metastases (P = 0.018). We show that high-risk node-negative colorectal cancer patients can be identified by primary tumor assessment for sLeX expression and LMVD. Our results are consistent with the notion that both lymphatic and hematogenous metastasis play a role in colorectal cancer.
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Affiliation(s)
- Fania S Doekhie
- Department of Surgery, K6-R, Leiden University Medical Center, Leiden, The Netherlands
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Miyakuni Y, Matsumoto T, Arakawa A, Sonoue H, Suzuki C, Takeda S. Lymphatic invasion according to D2-40 immunostaining is a predictor of nodal metastasis in endometrioid adenocarcinoma of the uterine corpus. Pathol Int 2008; 58:471-6. [DOI: 10.1111/j.1440-1827.2008.02258.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tomita N, Matsumoto T, Hayashi T, Arakawa A, Sonoue H, Kajiyama Y, Tsurumaru M. Lymphatic invasion according to D2-40 immunostaining is a strong predictor of nodal metastasis in superficial squamous cell carcinoma of the esophagus: algorithm for risk of nodal metastasis based on lymphatic invasion. Pathol Int 2008; 58:282-7. [PMID: 18429826 DOI: 10.1111/j.1440-1827.2008.02224.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In squamous cell carcinoma (SCC) of the esophagus, D2-40 immunostaining has recently been used to detect lymphatic invasion, but invasion detected using D2-40 immunostaining for a predictor of nodal metastasis was controversial. Therefore, the usefulness of detecting lymphatic invasion by D2-40 immunostaining as a predictor of nodal metastasis was examined in superficial (mucosal and submucosal) SCC of the esophagus. A total of 115 superficial SCC of the esophagus were examined on immunohistochemistry using D2-40. It was found that lymphatic invasion demonstrated on D2-40 immunostaining was mainly detected in the lamina propria mucosa. Lymphatic invasion was found in 37 cases and the invasion detected in the entire tumor tissue was statistically correlated with nodal metastasis. Based on the lymphatic invasion according to D2-40 immunostaining, an algorithm was devised for the risk (low, intermediate and high) of nodal metastases in superficial SCC in the esophagus. In conclusion, the detection of lymphatic invasion on D2-40 immunostaining in tumor tissue is a strong predictor for nodal metastasis in superficial SCC of the esophagus. Lymphatic invasion was found mainly in the lamia propria mucosa, thus the devised algorithm is useful for determining the optimal treatment strategy after endoscopic mucosal resection for esophageal SCC.
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Affiliation(s)
- Natsumi Tomita
- Department of Surgery, Juntendo University, School of Medicine, Tokyo, Japan
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Inoue M, Takakuwa T, Minami M, Shiono H, Utsumi T, Kadota Y, Nasu T, Aozasa K, Okumura M. Clinicopathologic factors influencing postoperative prognosis in patients with small-sized adenocarcinoma of the lung. J Thorac Cardiovasc Surg 2008; 135:830-6. [DOI: 10.1016/j.jtcvs.2007.10.034] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Revised: 09/03/2007] [Accepted: 10/19/2007] [Indexed: 10/22/2022]
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Yamada Y, Matsumoto T, Arakawa A, Ikeda S, Fujime M, Komuro Y, Takeda S. Evaluation using a combination of lymphatic invasion on D2-40 immunostain and depth of dermal invasion is a strong predictor for nodal metastasis in extramammary Paget's disease. Pathol Int 2008; 58:114-7. [DOI: 10.1111/j.1440-1827.2007.02198.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Amano T, Matsumoto T, Hayashi T, Arakawa A, Sonoue H, Kajiyama Y, Tsurumaru M. Subepithelial extension of squamous cell carcinoma in the esophagus: Histopathological study using D2-40 immunostaining for 108 superficial carcinomas. Pathol Int 2007; 57:759-64. [DOI: 10.1111/j.1440-1827.2007.02171.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sakuragi N. Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer. Int J Clin Oncol 2007; 12:165-75. [PMID: 17566838 DOI: 10.1007/s10147-007-0661-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Indexed: 10/23/2022]
Abstract
Lymph node metastasis (LNM), together with parametrial infiltration and positive surgical margins, is an important prognostic factor in cervical cancer. The incidence of LNM increases with International Federation of Gynecology and Obstetrics (FIGO) stage, with rates being 12%-22% in stage Ib, 10%-27% in stage IIa, and 34%-43% in stage IIb. Radical hysterectomy and pelvic lymphadenectomy are widely used treatments for early-stage (Ib to IIa) cervical cancer, as well as for stage IIb disease, in some European and Asian countries. In several types of cancer, the therapeutic significance of systematic lymphadenectomy has been demonstrated by recent reports showing that a larger number of lymph nodes removed relates to better survival. In cervical cancer, a significant relationship between the number of lymph nodes removed and disease-free survival has been reported in node-positive patients. Preoperative evaluation of nodal status with computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) imaging techniques is not sensitive enough to replace the histological examination of dissected nodes. The sentinel node procedure may be an alternative to systematic lymphadenectomy to reduce treatment-related morbidity, but more work on this is needed. Although the presence of LNM does not change FIGO staging, it will modulate postoperative therapy. Progression-free and overall survivals were significantly improved by the addition of chemotherapy to adjuvant radiotherapy after radical hysterectomy and lymphadenectomy. Adjuvant chemotherapy combined solely with radical hysterectomy and systematic lymphadenectomy may also provide a survival benefit. In conclusion, efforts to establish more tailored surgical strategies, by introducing advanced imaging technologies and molecular diagnostic procedures, are needed for cervical cancer.
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Affiliation(s)
- Noriaki Sakuragi
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
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Red-Horse K, Rivera J, Schanz A, Zhou Y, Winn V, Kapidzic M, Maltepe E, Okazaki K, Kochman R, Vo KC, Giudice L, Erlebacher A, McCune JM, Stoddart CA, Fisher SJ. Literature watch. Cytotrophoblast induction of arterial apoptosis and lymphangiogenesis in an in vivo model of human placentation. Lymphat Res Biol 2007; 4:229-42. [PMID: 17394406 DOI: 10.1089/lrb.2006.4407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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