title: Lymphatic vessel assessment by podoplanin (D2-40) immunohistochemistry in breast cancer.
abstract: BACKGROUND
  Lymph node metastasis has an important bearing on the staging of breast cancer. Lymph node metastasis occurs by hematogenous and lymphatic spread. The hematogenous and lymphatic spread can be quantified by the blood vessel and lymphatic vessel density in the intra-tumoral and peri-tumoral zone by specific markers for blood vessels and lymph vessels.
  
  
  OBJECTIVE
  In this study, we are trying to study the localization of podoplanin in lymph vessels of invasive breast carcinoma, to quantify lymphangiogenesis in tissue sections of invasive breast carcinomas by podoplanin immunohistochemistry (IHC) by D2-40 antibody, and compare it with blood microvessel count using CD-31 antibody and correlating clinicopathologic parameters with the results of IHC.
  
  
  METHODS
  IHC for biomarkers D2-40 and CD-31 were performed on sections from 30 mastectomy specimens to assess blood vessel and lymphatic vessel density in intra-tumoral and peri-tumoral zone. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 15.0 statistical analysis software.
  
  
  RESULTS
  The results showed that both lymph vessel density and blood vessel density increased with the increase in lymph node ratio. Lymph node ratio is the ratio of positive lymph nodes to the total number of lymph nodes removed.
  
  
  CONCLUSIONS
  Taking into account our small sample size, we conclude that a further large-sized study should be carried out to further prove the role of lymphatics in tumor dissemination. New therapeutic options can be developed targeting the lymphatic channels to arrest the lymphatic spread of the breast cancer.
authors.affiliation: Department of Pathology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Shailja Puri
authors.initials: SP
authors.lastname: Wahal
authors.forename: Madhu Mati
authors.initials: MM
authors.lastname: Goel
authors.forename: Raj
authors.initials: R
authors.lastname: Mehrotra
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D042583:Lymphangiogenesis; D042601:Lymphatic Vessels / Q000378:metabolism / Q000473:pathology*; D008562:Membrane Glycoproteins / Q000378:metabolism*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D000098853:Podoplanin
chemical_list: D014408:Biomarkers, Tumor; D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin