title: Vascular pattern in enchondroma and chondrosarcoma: clinical and immunohistologic study.
abstract: BACKGROUND
  Although cartilaginous tumors have low microvascular density, vessels are important for the provision of nutrition so that the tumor can grow and generate metastasis. The aim of this study was to assess the value of the vascular pattern classification as a prognostic tool in chondrosarcomas (CSs) and its relation with vascular endothelial growth factor (VEGF) expression.
  
  
  METHODS
  This was a retrospective study of 21 enchondromas and 57 conventional CSs. Clinical data and outcome were retrieved from medical files. CSs histologic grades (on a scale of 1 to 3) were determined according to the World Health Organization classification. The vascular pattern (on a scale of A to C) was assessed through CD34, according to Kalinski. CD105 and VEGF were also evaluated.
  
  
  RESULTS
  Poor outcome was significantly associated with vascular pattern groups B and C. Higher vascular pattern were 6.5 times more frequent in moderate-grade and high-grade CSs than in grade 1 CS. On multivariate analysis, a clear correlation was found between VEGF overexpression and B/C vascular patterns. Only 18 (benign and malignant) tumors stained for CD105.
  
  
  CONCLUSIONS
  The results point to the use of the vascular pattern classification as a prognostic tool in CSs and to differentiate low-grade from moderate-grade/high-grade CSs. Vascular pattern might be also used to complement histologic grade, VEGF immunostaining, and microvascular density, for indicating a patient's prognosis. Low-grade CSs develop under low neoangiogenesis, which conforms to the slow growth rate of these tumors.
authors.affiliation: *Unicamp- Department of Pathology †Orthopedics Department, UNICAMP ∥Pathology Department, Universidade Estadual de Campinas ‡Department of Orthopedics, Oncological Orthopedics Unit, Domingos Boldrini Children's Cancer Center §Orthopedics Department, Centro Medico de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Francisco F
authors.initials: FF
authors.lastname: Cintra
authors.forename: Mauricio
authors.initials: M
authors.lastname: Etchebehere
authors.forename: Jose C B
authors.initials: JC
authors.lastname: Gonçalves
authors.forename: Alejandro E
authors.initials: AE
authors.lastname: Cassone
authors.forename: Eliane M I
authors.initials: EM
authors.lastname: Amstalden
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology; D002812:Chondroma / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology; D002813:Chondrosarcoma / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D012189:Retrospective Studies