title: The location of lymphangiogenesis is an independent prognostic factor in rectal cancers with or without preoperative radiotherapy.
abstract: BACKGROUND
  Lymphangiogenesis and angiogenesis are essential for tumour development and progression. The lymphatic vessel density (LVD) and blood vessel density (BVD) and their relationship to outcome have been studied extensively, however the clinical significance of the location of LVD/BVD in tumour is not known. In the present study, the location and degree of LVD/BVD and their relationship to preoperative radiotherapy (RT), clinicopathological, histopathological and biological factors were studied in rectal cancer patients participating in a Swedish clinical trial of preoperative RT.
  
  
  METHODS
  The location and degree of LVD/BVD were analysed in primary tumours (n = 138/140) and in their subgroups of non-RT (n = 74) and RT (n = 64/66). Further, the degree of LVD/BVD was examined in the corresponding distant normal mucosa (n = 35/31) and adjacent normal mucosa (n = 72/91). All sections were immunohistochemically examined by using D2-40 and CD34 antibodies.
  
  
  RESULTS
  In the whole series of the patients, a higher LVD at the periphery was related to negative p53 expression (P = 0.03) and favourable survival independent of tumour-node-metastasis stage, differentiation and p53 expression (P = 0.03). LVD was increased in p53-negative tumours after RT (P = 0.01).
  
  
  CONCLUSIONS
  LVD at the periphery of the tumour was an independent prognostic factor in rectal cancer patients.
authors.affiliation: Department of Medical Oncology, Institute of Clinical and Experimental Medicine. Electronic address: annica.holmqvist@lio.se.
authors.forename: A
authors.initials: A
authors.lastname: Holmqvist
authors.affiliation: Department of Medical Oncology, Institute of Clinical and Experimental Medicine.
authors.forename: J
authors.initials: J
authors.lastname: Gao
authors.affiliation: Department of Medical Oncology, Institute of Clinical and Experimental Medicine.
authors.forename: G
authors.initials: G
authors.lastname: Adell
authors.affiliation: Department of Health and Society, Faculty of Arts and Sciences, Linköping University, Linköping, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Carstensen
authors.affiliation: Department of Medical Oncology, Institute of Clinical and Experimental Medicine.
authors.forename: X-F
authors.initials: XF
authors.lastname: Sun
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000276:immunology; D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34 / Q000378:metabolism; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007668:Kidney / Q000473:pathology / Q000528:radiation effects; D042583:Lymphangiogenesis; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology* / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D012307:Risk Factors; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; C500987:monoclonal antibody D2-40