title: Prognostic significance of immunohistochemically detected blood and lymphatic vessel invasion in colorectal carcinoma: its impact on prognosis.
abstract: BACKGROUND
  The prognostic significance of blood vessel invasion (BVI) and lymphatic vessel invasion (LVI) is unclear. Because of the absence of specific markers for venous and lymphatic vessels, earlier studies could not reliably distinguish between BVI and LVI.
  
  
  METHODS
  By immunostaining for podoplanin and CD34 antigen, we retrospectively investigated LVI and BVI in 419 tissue specimens of colorectal carcinoma. We performed univariate and multivariate analysis of the clinicopathologic features, frequency of recurrence, and outcome of patients with or without LVI and BVI.
  
  
  RESULTS
  The use of hematoxylin and eosin (H&E) staining to identify BVI and LVI yielded a false positive rate of 9.1% and false negative rate of 12.6%. The incidence of BVI was significantly higher among tumors with LVI than tumors without LVI (P <.001). In logistic multivariate analysis, only LVI (P < .001) was associated with lymph node metastasis and BVI (P = .015) was associated with distant recurrence. Calculating the prognostic relevance, both two invasion types correlated with decreased survival in univariate analysis (both P <.001). In multivariate analysis, BVI (P =.024), lymph node status (P =.003) and tumor stage (P <.001) remained statistically significant factors for survival.
  
  
  CONCLUSIONS
  Our results suggest that immunohistologic evaluation of BVI and LVI could be useful in colorectal carcinoma indicating the risk of lymph node metastasis and recurrence, thereby contributing to prognostic evaluation.
authors.affiliation: Fourth Department of Surgery, Tokyo Medical University Kasumigaura Hospital, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan. lp212003@yahoo.com
authors.forename: Pin
authors.initials: P
authors.lastname: Liang
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakada
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Hong
authors.forename: Takanobu
authors.initials: T
authors.lastname: Tabuchi
authors.forename: Gyo
authors.initials: G
authors.lastname: Motohashi
authors.forename: Akira
authors.initials: A
authors.lastname: Takemura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakachi
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Kasuga
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tabuchi
mesh_terms: D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001808:Blood Vessels / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D042601:Lymphatic Vessels / Q000473:pathology*; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D000098853:Podoplanin
chemical_list: D018952:Antigens, CD34; D015415:Biomarkers; D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin