title: The expression of vascular endothelial growth factor-C correlates with lymphatic microvessel density and lymph node metastasis in prostate carcinoma: An immunohistochemical study.
abstract: OBJECTIVE
  To evaluate the expression of two different lymphatic vascular density (LVD) markers (D2-40 and LYVE-1) and a lymphangiogenic cytokine (Vascular Endothelial Growth Factor-C, [VEGF-C]) in prostate carcinoma and to investigate their relationship with the lymph node status.
  
  
  METHODS
  Archival material study of 92 non-consecutive radical prostatectomy specimens.
  
  
  METHODS
  The mean LVD was assessed immunohistochemically in 24 prostate carcinoma specimens from patients with clinically localized disease, who were found to have nodal metastasis (pN1), and was compared with 68 pN0 cases. Furthermore, the mean LVD, VEGF-C expression, and lymphatic invasion were examined in relation to lymph node involvement.
  
  
  RESULTS
  Peritumoral (but not intratumoral) mean LVD assessed by D2-40 was higher in pN1 tumors (P = 0.015). LYVE-1 expression was limited and not associated with lymph node status. The VEGF-C expression was higher in the N1 cases and also correlated with the increased mean LVD in both the peri- and intratumoral compartments. Lymphatic invasion was strongly associated with nodal metastasis and higher VEGF-C expression.
  
  
  CONCLUSIONS
  Our results indicate that increased peritumoral (but not intratumoral) LVD in the tumor specimen is associated with lymph node metastasis. Increased expression of VEGF-C is associated with higher LVD (in both intratumoral and peritumoral compartments) and with positive lymph node status, indicating a possible dual role in both lymphangiogenesis and lymphatic vessel invasion.
authors.affiliation: Department of Anatomy, School of Medicine, University of Patras, Rion, Greece.
authors.forename: Gyftopoulos
authors.initials: G
authors.lastname: Kostis
authors.affiliation: Department of Anatomy, School of Medicine, University of Patras, Rion, Greece.
authors.forename: Lilis
authors.initials: L
authors.lastname: Ioannis
authors.affiliation: Department of Pathology, School of Medicine, University of Patras, Rion, Greece.
authors.forename: Kourea
authors.initials: K
authors.lastname: Helen
authors.affiliation: Department of Anatomy, School of Medicine, University of Patras, Rion, Greece.
authors.forename: Papadaki
authors.initials: P
authors.lastname: Helen
keywords: Immunohistochemistry; lymphangiogenesis; prostate adenocarcinoma; vascular endothelial growth factor-C; vessel density