title: Lymphatic vessel density and lymph node metastasis in prostate cancer.
abstract: BACKGROUND
  Few data are available examining the significance of prostatic lymphatic vessel density (LVD) to lymph node metastasis in patients with prostate cancer. The purpose of this study was to determine the distribution of lymphatic vessels in non-carcinomatous prostate tissue, and investigate the relationship between LVD and lymph node status in prostate cancer.
  
  
  METHODS
  LVD, identified by D2-40 immunostaining, was evaluated in non-carcinomatous prostates (n = 7) and prostate cancer (n = 37). The staining pattern of D2-40 was compared with that of another lymphatic vessel marker, vascular endothelial growth factor (VEGF) receptor-3, and a blood vessel endothelial marker, CD34, in adjacent sections.
  
  
  RESULTS
  The D2-40 antigen, podoplanin, was expressed exclusively in lymphatic vessels within tumor and normal tissue in all specimens. There was no overlap between cell staining for D2-40 and CD34. Peritumoral LVD and peritumoral lymphatic invasion were significantly associated with lymph node metastasis. VEGF receptor-3 was expressed in a subset of D2-40+ lymphatic vessels.
  
  
  CONCLUSIONS
  We have demonstrated that peritumoral lymphatic vessels are likely to serve as major conduits for nodal metastasis in prostate cancer using D2-40 to decorate lymphatic endothelium marker podoplanin. Lack of coexpression of podoplanin and VEGF receptor-3 in some lymphatic vessels suggests the heterogeneity of lymphatic endothelial cells in prostate tissue.
authors.affiliation: Bernard O'Brien Institute of Microsurgery, Melbourne, Australia.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Zeng
authors.forename: Kenneth
authors.initials: K
authors.lastname: Opeskin
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Horvath
authors.forename: Robert L
authors.initials: RL
authors.lastname: Sutherland
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Williams
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology* / Q000556:secondary; D000911:Antibodies, Monoclonal / Q000378:metabolism; D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34 / Q000378:metabolism; D015331:Cohort Studies; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology; D042601:Lymphatic Vessels / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000473:pathology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D040321:Vascular Endothelial Growth Factor Receptor-3 / Q000378:metabolism; D000098853:Podoplanin
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34; D008562:Membrane Glycoproteins; D040321:Vascular Endothelial Growth Factor Receptor-3; C117468:PDPN protein, human; D000098853:Podoplanin; C500987:monoclonal antibody D2-40