title: Does a growing tumour volume induce lymphangiogenesis? A study of oral/oropharyngeal cancer.
abstract: OBJECTIVE
  Tumour cell metastasis to regional lymph nodes is an early event in the spread of metastatic tumour. We postulated that an increased primary tumour volume (PTV) may modulate cervical nodal metastasis by altering lymphangiogenesis.
  
  
  METHODS
  We investigated 48 patients who had previously been diagnosed with cancer of the oral cavity and oropharynx.
  
  
  METHODS
  The tumour area was manually outlined from an axial magnetic resonance imaging series. The three-dimensional reconstruction software automatically calculated the PTV. Immunohistochemical staining was performed with vascular endothelial growth factor (VEGF)-C, VEGF-D, and D2-40 monoclonal antibodies on the paraffin-embedded tissues obtained from the primary tumour.
  
  
  METHODS
  The associations among the semiquantitative scores of the VEGF-C/D stained cancer cells, lymphatic vessel density (LVD), and PTV were investigated.
  
  
  RESULTS
  PTV had a significant relationship with LVD (p  =  .037) and N+ disease (p  =  .024). VEGF-C expression was significantly associated with lymph node metastasis (p  =  .018), increased LVD (p < .001), and tumour differentiation (p  =  .015) . However, we found no significant relationship between VEGF-C expression and the PTV. Similarly, among the various clinical factors, we found that the N stage (p  =  .001) and LVD (p  =  .008) were significantly associated with VEGF-D expression. However there was no association between VEGF-D expression and the primary PTV.
  
  
  CONCLUSIONS
  Although PTV had a significant relationship with LVD and N+ disease, we could not find any clear correlation between the expression of VEGF-C/D and the PTV.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Seoul, South Korea.
authors.forename: Eun-Jae
authors.initials: EJ
authors.lastname: Chung
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Rho
authors.forename: Seung-Kuk
authors.initials: SK
authors.lastname: Baek
authors.forename: Jeong-Soo
authors.initials: JS
authors.lastname: Woo
authors.forename: Soon-Young
authors.initials: SY
authors.lastname: Kwon
authors.forename: Nam-Joon
authors.initials: NJ
authors.lastname: Lee
authors.forename: Yang-Seok
authors.initials: YS
authors.lastname: Chae
authors.forename: Kwang-Yoon
authors.initials: KY
authors.lastname: Jung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000096:biosynthesis; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology; D042583:Lymphangiogenesis; D008207:Lymphatic Metastasis / Q000473:pathology; D042601:Lymphatic Vessels / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology*; D009960:Oropharynx / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D047368:Tumor Burden; D042582:Vascular Endothelial Growth Factor C / Q000096:biosynthesis; D042643:Vascular Endothelial Growth Factor D / Q000096:biosynthesis
chemical_list: D014408:Biomarkers, Tumor; D042582:Vascular Endothelial Growth Factor C; D042643:Vascular Endothelial Growth Factor D