title: Angiogenesis at the site of deepest penetration predicts lymph node metastasis of submucosal colorectal cancer.
abstract: OBJECTIVE
  Intratumor microvessel count has been reported as a useful prognostic factor in patients with cancer of various organs. This study was undertaken to clarify the relation between microvessel count and lymph node metastasis in submucosal colorectal cancer.
  
  
  METHODS
  Microvessel count was estimated in 254 invasive tumors that had been resected from patients with submucosal colorectal cancer. Immunohistochemistry with antibodies against CD34 was performed on archival specimens, and microvessel counts were estimated based on the average count of three fields (original magnification, x400) in the most vascular area at the site of deepest submucosal penetration.
  
  
  RESULTS
  Microvessel count ranged from 10 to 98, with a median of 40. Lesions with high microvessel counts (> or =40) had a significantly higher incidence of lymph node metastasis than those with low microvessel counts (<40; 21.8 percent vs. 6.2 percent). None of the 79 lesions with low microvessel counts and submucosal invasion up to a depth of 1,500 microm had metastasized to the lymph nodes. In multivariate analysis, microvessel count was an independent risk factor for lymph node metastasis in submucosal colorectal cancer (P = 0.0026).
  
  
  CONCLUSIONS
  Microvessel count at the site of deepest submucosal penetration can be one of the most useful predictors for lymph node metastasis. Analysis that combines microvessel count and depth of submucosal invasion may predict the occurrence of lesions without lymph node metastasis.
authors.affiliation: First Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8551, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Oh-e
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.forename: Y
authors.initials: Y
authors.lastname: Kitadai
authors.forename: F
authors.initials: F
authors.lastname: Shimamoto
authors.forename: M
authors.initials: M
authors.lastname: Yoshihara
authors.forename: K
authors.initials: K
authors.lastname: Haruma
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply* / Q000473:pathology; D018256:Adenomatous Polyps / Q000098:blood supply* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000098:blood supply* / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D007413:Intestinal Mucosa / Q000098:blood supply / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008833:Microcirculation / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011379:Prognosis