Significance of lymphangiogenesis as assessed by immunohistochemistry for podoplanin in patients with esophageal carcinoma.
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.
Nakayama
Yoshifumi
Y
Department of Surgery 1, University of Occupational and Environmental Health, Yahata-nishi-ku, Kita-kyushu 807-8555, Japan. nakayama@med.uoeh-u.ac.jp
Matsumoto
Kentaro
K
Nagato
Masaru
M
Inoue
Yuzuru
Y
Katsuki
Takefumi
T
Minagawa
Noritaka
N
Shibao
Kazunori
K
Tsurudome
Yosuke
Y
Hirata
Keiji
K
Higure
Aiichiro
A
Sako
Tatsuhiko
T
Nagata
Naoki
N
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
D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin