title: High density of peritumoral lymphatic vessels measured by D2-40/podoplanin and LYVE-1 expression in gastric cancer patients: an excellent prognostic indicator or a false friend?
abstract: BACKGROUND
  One of the most important prognostic indicators in gastric cancer is the presence of metastases in lymph nodes. Even now, little is known about lymphangiogenesis in neoplastic tissue, and little is also known about the transmission of a neoplastic cell from the tumor mass into a lymphatic vessel.
  
  
  METHODS
  This study examined the relationships between the density of lymphatic vessels (LVD) stained immunohistochemically with lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) and D2-40 (podoplanin) antibodies, the expression of vascular endothelial growth factor (VEGF)-C/D, selected clinical and pathomorphological factors, and the 5-year overall survival of gastric cancer patients.
  
  
  RESULTS
  Statistical analysis showed no impact of increased intratumoral or peritumoral LVD on gastric cancer patient survival, irrespective of the protein used to stain lymphatic vessels. Analysis showed that the probability of overall survival was decreased in the cases with enhanced VEGF-D immunoreactivity (P = 0.0045).
  
  
  CONCLUSIONS
  The study showed that the studied markers cannot be used to determine the required extent of the surgical procedure, as they have no statistically significant correlation with the degree of progression of the cancer, the stage of the disease assessed according to the TNM 5th classification of malignant tumors, clinicopathological features, and patient survival. VEGF-D is the only marker that can be regarded as an unfavorable prognostic indicator for patients with advanced gastric cancer.
authors.affiliation: 2nd Department of General and Oncological Surgery, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland, jrr@id.pl.
authors.forename: Julia
authors.initials: J
authors.lastname: Rudno-Rudzinska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kielan
authors.forename: Zygmunt
authors.initials: Z
authors.lastname: Grzebieniak
authors.forename: Piotr
authors.initials: P
authors.lastname: Dziegiel
authors.forename: Piotr
authors.initials: P
authors.lastname: Donizy
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Mazur
authors.forename: Monika
authors.initials: M
authors.lastname: Knakiewicz
authors.forename: Ewelina
authors.initials: E
authors.lastname: Frejlich
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Halon
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000378:metabolism*; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism*; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D042582:Vascular Endothelial Growth Factor C / Q000378:metabolism; D042643:Vascular Endothelial Growth Factor D / Q000378:metabolism; D033921:Vesicular Transport Proteins / Q000378:metabolism*; D000098853:Podoplanin
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D008562:Membrane Glycoproteins; D042582:Vascular Endothelial Growth Factor C; D042643:Vascular Endothelial Growth Factor D; D033921:Vesicular Transport Proteins; C119248:LYVE1 protein, human; C117468:PDPN protein, human; D000098853:Podoplanin; C467486:VEGFC protein, human; C579459:VEGFD protein, human; C500987:monoclonal antibody D2-40; C031192:oncofetal antigens