title: Impact of microvessel density on lymph node metastasis and survival after curative resection of pancreatic cancer.
abstract: OBJECTIVE
  The roles of angiogenesis and the most prominent angiogenic vascular endothelial growth factor (VEGF) in diseases of the pancreas remain controversial. We compared microvessel density (MVD) and VEGF status in normal pancreatic, chronic pancreatic, and pancreatic cancer (PC) tissues to establish their prognostic relevance.
  
  
  METHODS
  Eighty samples of PC tissue, 32 samples of normal pancreatic tissue, and 20 samples of chronic pancreatitis (cP) tissue were immunostained with monoclonal anti-CD31 and polyclonal anti-VEGF antibody. The MVD was correlated with clinicopathological features and survival.
  
  
  RESULTS
  Microvessel density was higher in PC than in cP (P < 0.001). Residual tumor status was highly predictive for survival (P < 0.001). After stratification for residual tumor status, we identified lymph node metastasis (LNM) in more than two lymph nodes (P < 0.04) and high MVD (P < 0.03) as risk factors for mortality. Multivariate analysis revealed only a high MVD (P = 0.03, odds ratio 0.441, 95% confidence interval 0.211-0.821) as an independent predictor of poor survival. Vascular endothelial growth factor was found over stromal cells in cP and over ductal adenocarcinoma cells in PC. Vascular endothelial growth factor expression status was not predictive of survival (P < 0.07).
  
  
  CONCLUSIONS
  This study confirms the role of angiogenesis in PC and identifies MVD as an independent prognostic factor in patients with curatively resected PC.
authors: Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany. christoph.benckert@medizin.uni-leipzig.de
authors: Christoph
authors: C
authors: Benckert
authors: Armin
authors: A
authors: Thelen
authors: Thorsten
authors: T
authors: Cramer
authors: Wilko
authors: W
authors: Weichert
authors: Gereon
authors: G
authors: Gaebelein
authors: Reinhard
authors: R
authors: Gessner
authors: Sven
authors: S
authors: Jonas
mesh_terms: D000328:Adult; D000368:Aged; D002452:Cell Count; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000401:mortality / Q000473:pathology*; D010179:Pancreas / Q000098:blood supply* / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000098:blood supply* / Q000401:mortality / Q000556:secondary; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D042461:Vascular Endothelial Growth Factor A / Q000096:biosynthesis
chemical_list: D042461:Vascular Endothelial Growth Factor A