Clinical significance of microvessel count in patients with metastatic liver cancer originating from colorectal carcinoma.
BACKGROUND
Microvessel count (MVC) has been correlated with patient prognosis in hepatocellular carcinoma. We investigated whether MVC assessed by staining with CD34 antibody was associated with disease-free and overall survival in patients with metastatic liver cancer (MLC).


METHODS
We examined relationships between MVC and clinicopathologic factors or postoperative outcomes in 139 MLC patients who underwent hepatectomy between 1990 and 2006. CD34 expression was analyzed by the immunohistochemical method.


RESULTS
MVC was associated with fibrous pseudocapsular formation on histological examination. By means of the modern Japanese classification of liver metastasis, poorer survival was associated with higher score, poorly differentiated adenocarcinoma, higher preoperative carcinoembryonic antigen (CEA) level, fibrous pseudocapsular formation, and smaller surgical margin. Shorter disease-free survival was associated with higher score when the Japanese classification of liver metastasis was used, multiple or bilobar tumor, regional lymph node metastasis in primary colon carcinoma, preoperative CEA level, fibrous pseudocapsular formation, and smaller surgical margin (<5 mm). Higher MVC (>or=406/mm(2)) was associated with decreased disease-free and overall survival by univariate analysis (P = .034 and P = .021, respectively), and higher MVC represented an independently poor prognostic factor in overall survival by Cox multivariate analysis (risk ratio, 2.71; P = .023) in addition to histological differentiation.


CONCLUSIONS
Tumor MVC seems to be a useful prognostic marker of MLC patient survival.
Nanashima
Atsushi
A
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Shibata
Kenichirou
K
Nakayama
Toshiyuki
T
Tobinaga
Syuuichi
S
Araki
Masato
M
Kunizaki
Masaki
M
Takeshita
Hiroaki
H
Hidaka
Shigekazu
S
Sawai
Terumitsu
T
Nagayasu
Takeshi
T
Yasutake
Toru
T
D000230:Adenocarcinoma / Q000098:blood supply* / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D007124:Immunoenzyme Techniques; D008113:Liver Neoplasms / Q000098:blood supply* / Q000556:secondary / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
D018952:Antigens, CD34