Morphometric microvascular characteristics in the prognosis of pancreatic and ampullary carcinoma.
OBJECTIVE
To evaluate multiple morphometric microvascular characteristics in addition to microvascular density (MVD) in pancreatic ductal and ampullary adenocarcinomas and provide a better approach in examining the relationship among angiogenesis, several clinicopathologic parameters, and prognosis.


METHODS
Histological sections from 32 pancreatic ductal and 17 ampullary adenocarcinomas, immunostained with CD34, were evaluated by image analysis for the quantification of MVD, total vascular area, and microvascular branching, as well as several morphometric parameters related to the vessel size and shape factor.


RESULTS
In pancreatic ductal carcinoma, higher levels of MVD, total vascular area, branching, and shape factor were related to N1 tumors. Moreover, MVD, shape factor, and minor axis length were identified as independent prognostic factors of survival. In the ampullary carcinoma group, higher shape factor values were observed in well-differentiated tumors.


CONCLUSIONS
In pancreatic ductal carcinoma patients, the assessment of MVD and several morphometric microvascular characteristics provides significant prognostic information. The biologic behavior of the ampullary carcinomas does not seem to be dependent on any of the above mentioned factors of angiogenesis.
Giannopoulos
George
G
Fourth Surgical Department, Attikon Hospital, University of Athens, Athens, Greece. geogianno@med.uoa.gr
Kavantzas
Nikolaos
N
Parasi
Aikaterini
A
Tiniakos
Dina
D
Peros
George
G
Tzanakis
Nikolaos
N
Patsouris
Efstratios
E
Pavlakis
Kitty
K
D000230:Adenocarcinoma / Q000098:blood supply* / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D018952:Antigens, CD34 / Q000378:metabolism; D021441:Carcinoma, Pancreatic Ductal / Q000098:blood supply* / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D008297:Male; D008833:Microcirculation / Q000473:pathology; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology; D010179:Pancreas / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D010183:Pancreatic Ducts / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000098:blood supply* / Q000401:mortality / Q000473:pathology*; D011379:Prognosis
D018952:Antigens, CD34