title: Intratumoral lymphatic vessel density in vulvar squamous cell carcinomas:  a possible association with favorable prognosis.
abstract: Lymphatic vessels serve as major routes for regional dissemination, and therefore, lymph node status is a key indicator of prognosis. To predict lymph node metastasis, tumor lymphatic density and lymphangiogenesis-related molecules have been studied in various tumor types. To our knowledge, no previous studies have evaluated the role of intratumoral lymphatic vessel density (LVD) in the behavior of vulvar carcinomas. The aim of this study was to analyze intratumoral LVD in relation to patient survival and well-characterized prognostic factors for cancer. Thirty-five patients with vulvar squamous cell carcinoma underwent vulvectomy and dissection of regional lymph nodes. Clinical records were reviewed, in addition to histological grade, peritumoral lymphatic invasion, and depth of infiltration for each case. Tissue microarray paraffin blocks were created, and lymphatic vessels were detected using immunohistochemical staining of podoplanin (D2-40 antibody). Intratumoral LVD was quantified by counting the number of stained vessels. Higher values for intratumoral LVD were associated with low-grade and low-stage tumors, and with tumors without lymphatic invasion and reduced stromal infiltration. In a univariate analysis, high intratumoral LVD was associated with a higher rate of overall survival and a lower rate of lymph node metastasis. Our results suggest that increased intratumoral LVD is associated with favorable prognosis in vulvar squamous carcinomas.
authors: Department of Obstetrics and Gynaecology, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
authors: Renata Sampaio
authors: RS
authors: Goes
authors: Jesus P
authors: JP
authors: Carvalho
authors: Bernardo G L
authors: BG
authors: Almeida
authors: Carlos E
authors: CE
authors: Bacchi
authors: Joao Carlos Sampaio
authors: JC
authors: Goes
authors: Marcelo Alvarenga
authors: MA
authors: Calil
authors: Edmund C
authors: EC
authors: Baracat
authors: Filomena M
authors: FM
authors: Carvalho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D042583:Lymphangiogenesis; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016612:Paraffin Embedding; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014846:Vulvar Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor