Intranodal lymphangiogenesis precedes development of lymph node metastasis and accelerates progression of gastric cancer.
BACKGROUND
Peritumoral lymphangiogenesis is significantly correlated with lymph node metastasis and poor prognosis in various cancers. However, there are few reports concerning the role of intranodal lymphangiogenesis in lymphatic metastasis. The aim of this study was to examine the association of lymphangiogenesis in regional lymph nodes with the progression of gastric cancer.


METHODS
Lymphatic vessel density (LVD) was immunohistochemically estimated in 1,596 lymph nodes from 52 patients who underwent gastrectomy.


RESULTS
Intranodal LVD was significantly correlated with the size of metastasis and the progression of cancer. Patients in the high LVD group had significantly poorer prognosis relative to patients in the low LVD group. Furthermore, expression of VEGF-C mRNA was significantly up-regulated in lymph nodes of pathological node positive patients compared to node negative patients.


CONCLUSIONS
Thus, intranodal lymphangiogenesis was correlated with nodal metastasis and poor prognosis of patients with gastric cancer. Lymphangiogenesis in regional lymph nodes plays an early role in spreading of tumor cells through the lymphatic system to distant organs in gastric cancer.
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan, mao5819@yahoo.co.jp.
Mao
M
Watanabe
Hiroaki
H
Tanaka
Masaichi
M
Ohira
Mami
M
Yoshii
Katsunobu
K
Sakurai
Takahiro
T
Toyokawa
Naoshi
N
Kubo
Atsushi
A
Yamamoto
Kazuya
K
Muguruma
Yoshito
Y
Yamashita
Kiyoshi
K
Maeda
Tetsuji
T
Sawada
Kosei
K
Hirakawa
D002277:Carcinoma / Q000556:secondary* / Q000601:surgery; D018450:Disease Progression; D018572:Disease-Free Survival; D042783:Endothelial Cells / Q000737:chemistry; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000503:physiopathology; D042583:Lymphangiogenesis; D008207:Lymphatic Metastasis / Q000473:pathology / Q000503:physiopathology*; D042601:Lymphatic Vessels / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012333:RNA, Messenger / Q000378:metabolism; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D015854:Up-Regulation; D042582:Vascular Endothelial Growth Factor C / Q000235:genetics
D012333:RNA, Messenger; D042582:Vascular Endothelial Growth Factor C