Tumor angiogenesis in lymph node-negative rectal cancer: correlation with clinicopathological parameters and prognosis.
BACKGROUND
Intratumoral microvessel density (MVD) could be used as a prognostic factor in colorectal cancer. We retrospectively analyzed the value of microvessel count in predicting the clinical outcome of stage I and II (Dukes A and B) rectal cancer patients.


METHODS
Eighty-four patients who had undergone curative resection of lymph node-negative rectal cancer were included. Tumor type and differentiation, the depth of local invasion, venous invasion, the character of the invasive margin, and the degree of lymphocytic infiltration were evaluated for each tumor specimen. Immunohistochemical staining for the CD31 endothelial antigen was performed to highlight the microvessels.


RESULTS
The median value of MVD was 45 microvessels. Low MVD (microvessels < or = 45) was observed in 41 patients (48.8%), and high MVD (>45) was found in 43 (51.2%). The presence of conspicuous lymphocytic infiltration was significantly associated with increased vessel density. With uni- and multivariate survival analysis MVD did not show any prognostic significance. The character of the invasive margin was the only parameter with independent prognostic value.


CONCLUSIONS
MVD does not seem to provide any additional prognostic information when compared with standard histopathological parameters in lymph node-negative rectal cancer. It is likely that the strong association between MVD and the presence of conspicuous lymphocytic infiltration may interfere with its predictive value.
Cianchi
Fabio
F
Department of General Surgery, University of Florence, Italy. cianchif@mail.unifi.it
Palomba
Annarita
A
Messerini
Luca
L
Boddi
Vieri
V
Asirelli
Grazia
G
Perigli
Giuliano
G
Bechi
Paolo
P
Taddei
Antonio
A
Pucciani
Filippo
F
Cortesini
Camillo
C
D000230:Adenocarcinoma / Q000098:blood supply* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000098:blood supply* / Q000473:pathology*; D012189:Retrospective Studies; D016019:Survival Analysis