title: The clinical significance of lymphangiogenesis and angiogenesis in non-small cell lung cancer patients.
abstract: BACKGROUND
  Angiogenesis and lymphangiogenesis have been reported to affect malignant phenotype.
  
  
  METHODS
  We investigated 147 patients with non-small cell lung cancer (NSCLC). Immunohistochemistry using D2-40 was performed to evaluate lymphatic vessel density (LVD), including Micro-LVD (without lumen), Tubal-LVD (with lumen) and lymphatic vessel invasion (LVI). The intratumoural microvessel density (MVD) was evaluated by CD-34 immunostaining. The expressions of vascular endothelial growth factor-A (VEGF-A) and VEGF-C were also studied.
  
  
  RESULTS
  Lymphangiogenesis was significantly associated with Micro-LVD (p=0.0003). The VEGF-C expression was significantly associated with the Micro-LVD (p=0.0057). In contrast, the VEGF-A expression was significantly associated with the MVD (p=0.0092). The survival was significantly lower in patients with Micro-LVD-high tumours than in patients with Micro-LVD-low tumours (p=0.0397). Survival was also significantly lower in patients with MVD-high tumours than in patients with MVD-low tumours (p=0.0334). A multivariate analysis demonstrated that the Micro-LVD (p=0.0363) and the MVD (p=0.0232) were independent prognostic factors for NSCLC patients.
  
  
  CONCLUSIONS
  Lymphangiogenesis, specifically Micro-LVD and angiogenesis are independently associated with a poor prognosis in NSCLC patients.
authors.affiliation: Department of General Thoracic Surgery, Breast and Endocrinological Surgery, Faculty of Medicine, Kagawa University, 1750-1 Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
authors.forename: Kyuichi
authors.initials: K
authors.lastname: Kadota
authors.forename: Cheng-Long
authors.initials: CL
authors.lastname: Huang
authors.forename: Dage
authors.initials: D
authors.lastname: Liu
authors.forename: Masaki
authors.initials: M
authors.lastname: Ueno
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kushida
authors.forename: Reiji
authors.initials: R
authors.lastname: Haba
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Yokomise
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000098:blood supply* / Q000401:mortality / Q000473:pathology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000098:blood supply* / Q000401:mortality / Q000473:pathology; D042583:Lymphangiogenesis / Q000502:physiology*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000401:mortality / Q000473:pathology*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D042582:Vascular Endothelial Growth Factor C / Q000378:metabolism
chemical_list: D042461:Vascular Endothelial Growth Factor A; D042582:Vascular Endothelial Growth Factor C