Lymphatic vessel density, nodal metastases, and prognosis in patients with head and neck cancer.
OBJECTIVE
To examine the relationship between intratumoral lymphatic vessel density and clinical and pathological variables in patients with head and neck squamous cell carcinoma.


METHODS
Archived paraffin-embedded biopsy specimens were sectioned and stained with hematoxylin-eosin and anti-LYVE-1 antibody, a highly specific marker for lymphatic endothelium. Tumor grade, infiltrating margin, inflammatory infiltrate, and percentage of tumor necrosis were noted and lymphatic vessel density measured using Chalkley point counting.


METHODS
Tertiary care center at a university hospital.


METHODS
A total of 168 previously untreated patients with advanced squamous cell carcinoma (73, larynx; 62, oropharynx; and 33, hypopharynx) treated with primary radiation (with or without planned neck dissection) and salvage surgery from 1992 to 1999.


METHODS
Measurement of intratumoral lymphatic vessel density in pretreatment tissue biopsy specimen.


METHODS
Disease-free and disease-specific survival, tumor occurrence, and nodal status.


RESULTS
In patients with laryngeal carcinoma there was a significant relationship between the presence of intratumoral lymphatics and nodal metastases at presentation (P = .02) and poorly differentiated tumor grade (P = .02). Patients with high lymphatic vessel density also had a significantly worse disease-specific survival (P = .03). However, this difference was not significant with multivariate analysis. No significant relationship existed between the presence of intratumoral lymphatics and any of the clinical or pathological variables in oropharyngeal and hypopharyngeal carcinoma.


CONCLUSIONS
In this patient sample, the development of intratumoral lymphatics in laryngeal carcinoma, but not in oropharyngeal or hypopharyngeal carcinoma, is associated with a spread of the tumor to regional lymph nodes. Detecting tumor lymphatic vessel proliferation is another step in the understanding of tumor biology, and the targeting of lymphatic growth may be of potential therapeutic benefit in selected patients with head and neck squamous cell carcinoma.
Audet
Nathalie
N
Department of Otolaryngology, Wharton Head and Neck Centre, Princess Margaret Hospital, University of Toronto, Ontario, Canada.
Beasley
Nigel J
NJ
MacMillan
Christina
C
Jackson
David G
DG
Gullane
Patrick J
PJ
Kamel-Reid
Suzanne
S
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary; D018572:Disease-Free Survival; D005260:Female; D006023:Glycoproteins / Q000378:metabolism; D006258:Head and Neck Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology; D007150:Immunohistochemistry; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D016019:Survival Analysis; D033921:Vesicular Transport Proteins
D006023:Glycoproteins; C119248:LYVE1 protein, human; D033921:Vesicular Transport Proteins