title: Clinical value of immunohistochemically detected lymphovascular space invasion in early stage cervical carcinoma.
abstract: BACKGROUND
  This study investigates the clinical significance of lymphovascular space invasion (LVSI) as detected by hematoxylin and eosin (LVSI-H&E) and immunohistochemistry (LVSI-IHC) in early stage cervical carcinoma.
  
  
  METHODS
  Single representative sections from 97 patients with early stage squamous cell cervical cancer were immunostained with pancytokeratin and CD31 endothelial cell marker antibodies. The H&E sections and their corresponding immunostained sections were reexamined to identify LVSI. Associations between LVSI with clinicopathological factors were sought.
  
  
  RESULTS
  Overall, LVSI was present in 29 (29.9%) and absent in 68 (70.1%) by IHC, as compared with 18 cases (18.6%) and 79 cases (81.4%), respectively, by H&E. Statistical analysis revealed a significant association between LVSI-H&E and nodal metastasis (P = .004). Follow-up data were available for 76 patients. The median follow-up period was 64 months. During follow-up, 7 of 24 patients with recurrent disease had evidence of LVSI-H&E as opposed to 3 of 52 cases with no recurrence. There was a significant association between tumor recurrence and LVSI-H&E (P = .009). The 5-year recurrence-free survival was 30% for the group with LVSI-H&E compared with 73% without. There was a significant difference in the recurrence-free survival between the two groups (P = .002). In contrast LVSI-IHC was found to be associated with no pathological factors, and survival analysis revealed no statistically significant association with recurrence or survival.
  
  
  CONCLUSIONS
  LVSI-H&E in early stage cervical cancer remains an important predictive factor of recurrent disease and reduced disease-free interval. Immunohistochemically detected LVSI is a common event and seems to be of no clinical value.
authors.affiliation: Cancer Research-United Kingdom Translational Oncology Laboratory, St. Bartholomew's and the Royal London School of Medicine and Dentistry, John Vane Building, Charterhouse Square, London, EC1M 6BQ, UK. cslim@doctors.org.uk
authors.forename: Chung Sim
authors.initials: CS
authors.lastname: Lim
authors.forename: Farhad
authors.initials: F
authors.lastname: Alexander-Sefre
authors.forename: Mohamed
authors.initials: M
authors.lastname: Allam
authors.forename: Naveena
authors.initials: N
authors.lastname: Singh
authors.forename: Joanne Chin
authors.initials: JC
authors.lastname: Aleong
authors.forename: Haytham
authors.initials: H
authors.lastname: Al-Rawi
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011379:Prognosis; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery