title: Significance of lymphangiogenesis as assessed by immunohistochemistry for podoplanin in patients with esophageal carcinoma.
abstract: BACKGROUND
  Although lymph node involvement is an important prognostic factor for survival in patients with esophageal carcinoma, little is known about lymphangiogenesis in esophageal carcinoma. Podoplanin, a mutin-type transmembrane glycoprotein, specifically recognizes the lymphatic endothelium and is used as a lymphatic-specific marker. Anti-human podoplanin antibody was therefore used to quantify and evaluate the lymphangiogenesis in esophageal carcinoma.
  
  
  METHODS
  Lymphatic endothelial cells were detected by immunohistochemistry using mouse monoclonal anti-human podoplanin antibody. The relationship between lymphatic microvessel density (LMVD) and lymphatic vessel invasion (LVI), clinicopathological factors and the prognosis in 29 patients with esophageal carcinoma was investigated.
  
  
  RESULTS
  LMVD was significantly higher in esophageal carcinoma patients who had any of the following characteristics: T3-T4 (p=0.0370), tumors more advanced than stage III (TNM staging) (p=0.0351), lymphatic invasion (p=0.0095) and LVI (+) (p=0.0016). LVI significantly correlated with lymph node metastasis (p=0.0003), TNM staging (p=0.0182) and LMVD (p=0.0388). The survival rate of patients with a low LMVD tended to be higher than that of patients with a high LMVD (5-year survival rate, 62.5% vs. 29.4%, p=0.0832).
  
  
  CONCLUSIONS
  The evaluation of lymphangiogenesis using podoplanin immunohistochemistry may be useful in predicting lymph node metastasis and the prognosis in patients with esophageal carcinoma.
authors.affiliation: Department of Surgery 1, University of Occupational and Environmental Health, Yahata-nishi-ku, Kita-kyushu 807-8555, Japan. nakayama@med.uoeh-u.ac.jp
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Kentaro
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Masaru
authors.initials: M
authors.lastname: Nagato
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Inoue
authors.forename: Takefumi
authors.initials: T
authors.lastname: Katsuki
authors.forename: Noritaka
authors.initials: N
authors.lastname: Minagawa
authors.forename: Kazunori
authors.initials: K
authors.lastname: Shibao
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tsurudome
authors.forename: Keiji
authors.initials: K
authors.lastname: Hirata
authors.forename: Aiichiro
authors.initials: A
authors.lastname: Higure
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Sako
authors.forename: Naoki
authors.initials: N
authors.lastname: Nagata
mesh_terms: D000368:Aged; D004729:Endothelium, Lymphatic / Q000737:chemistry / Q000473:pathology; D004938:Esophageal Neoplasms / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D042583:Lymphangiogenesis; D042601:Lymphatic Vessels / Q000737:chemistry / Q000473:pathology*; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis*; D008875:Middle Aged; D011379:Prognosis; D000098853:Podoplanin
chemical_list: D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin