title: Prognostic value of lymphangiogenesis in supraglottic laryngeal carcinoma.
abstract: BACKGROUND
  Metastasis to regional lymph nodes via lymphatic microvessels plays a key role in cancer progression, and is an important prognostic factor in many cancers. Recent evidence suggests that tumour lymphangiogenesis promotes lymphatic metastasis.
  
  
  OBJECTIVE
  To investigate whether tumour lymphatic microvessel density correlates with clinicopathological factors and serves as a prognostic indicator of supraglottic laryngeal carcinoma progression.
  
  
  METHODS
  The lymphatics of 84 supraglottic laryngeal carcinoma cases were investigated by immunohistochemical staining for podoplanin (also termed D2-40). The relationships between (intra- and peritumoural) lymphatic microvessel density, clinicopathological parameters and clinical prognosis were analysed.
  
  
  RESULTS
  There was a significant relationship between high intratumoural lymphatic microvessel density and aggressive tumour node stage (p < 0.0001), distant metastasis (p = 0.037) and poor prognosis (p = 0.011), and between high peritumoural lymphatic microvessel density and node stage (p = 0.004) and poor prognosis (p = 0.029). Patients with high lymphatic microvessel density also had significantly worse disease-free survival (p = 0.003) and overall survival (p = 0.005). Intratumoural lymphatic microvessel density was found to be an independent prognostic factor for overall survival (p = 0.008) and disease-free survival (p = 0.005) (multivariate analysis).
  
  
  CONCLUSIONS
  Lymphatic microvessel density (detected by podoplanin immunohistochemistry), especially intratumoural density, may be an independent predictor of lymphatic tumour spread and survival in supraglottic laryngeal carcinoma patients, and may be useful to guide decisions regarding additional surgery.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiaotong University, China.
authors.forename: J Y
authors.initials: JY
authors.lastname: Lin
authors.forename: X Y
authors.initials: XY
authors.lastname: Li
authors.forename: P
authors.initials: P
authors.lastname: Dong
authors.forename: T
authors.initials: T
authors.lastname: Nakashima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D002277:Carcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D002294:Carcinoma, Squamous Cell; D005260:Female; D005931:Glottis; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D042583:Lymphangiogenesis; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism; D008875:Middle Aged; D009367:Neoplasm Staging; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D000098853:Podoplanin
chemical_list: D014408:Biomarkers, Tumor; D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin