title: Lymph vessel density in seminomatous testicular cancer assessed with the specific lymphatic endothelium cell markers D2-40 and LYVE-1: correlation with pathologic parameters and clinical outcome.
abstract: OBJECTIVE
  To evaluate the role of lymph vessel density (LVD) and lymphangiogenesis in seminomatous testicular cancer (STC) by using the lymphatic endothelial cell (LEC) markers LYVE-1 and D2-40.
  
  
  METHODS
  Paraffin embedded tumor specimens from 40 patients with STC were stained by specific D2-40 and Lyve-1 antibodies. LVD was measured in different representative and standardized areas. Fluorescence double immunostaining for Lyve-1 and Ki-67 was performed and results were correlated with clinicopathologic data. The median follow-up period was 55 (range 10-135) months.
  
  
  RESULTS
  Mean intratumoral LVD (D2-40: 1.30 ± 1.99; Lyve-1: 1.82 ± 2.34) was significantly lower than peritumoral LVD (D2-40: 4.94 ± 2.58; Lyve-1: 4.62 ± 2.73) and LVD in nontumoral areas (D2-40: 4.81 ± 3.79; Lyve-1: 4.22 ± 3.19). There was no significant difference between LVD measures when using D2-40 or LYVE-1. Detection rates of lymphatic vascular invasion (LVI) were significantly higher than in conventional HE-stained sections (77.5% vs. 52.5%). No proliferating lymphatic vessels were found.
  
  
  CONCLUSIONS
  We found that LVD is decreased within tumor areas of STC. Despite a higher peritumoral LVD, no signs of proliferating endothelial cells were observed, suggesting a lack of lymphangiogenesis in STC. Detection of LVI can be optimized by specific D2-40 or LYVE-1 staining.
authors.affiliation: Department of Urology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany. Electronic address: julia.heinzelbecker@umm.de.
authors.forename: Julia
authors.initials: J
authors.lastname: Heinzelbecker
authors.forename: Kai-Michael
authors.initials: KM
authors.lastname: Kempf
authors.forename: Katrin
authors.initials: K
authors.lastname: Kurz
authors.forename: Annette
authors.initials: A
authors.lastname: Steidler
authors.forename: Christel
authors.initials: C
authors.lastname: Weiss
authors.forename: David G
authors.initials: DG
authors.lastname: Jackson
authors.forename: Christian
authors.initials: C
authors.lastname: Bolenz
authors.forename: Axel
authors.initials: A
authors.lastname: Haecker
authors.forename: Lutz
authors.initials: L
authors.lastname: Trojan
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D042783:Endothelial Cells / Q000378:metabolism* / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D042583:Lymphangiogenesis; D042601:Lymphatic Vessels / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D013736:Testicular Neoplasms / Q000378:metabolism* / Q000473:pathology; D033921:Vesicular Transport Proteins / Q000378:metabolism*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; C119248:LYVE1 protein, human; D033921:Vesicular Transport Proteins; C500987:monoclonal antibody D2-40