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Objective:To evaluate the value of preoperative prediction of vessel invasion (VI) of locally advanced gastric cancer by machine learning model based on the venous phase enhanced CT radiomics features.Methods:A retrospective analysis of 296 patients with locally advanced gastric cancer confirmed by pathology in the First Affiliated Hospital of Zhengzhou University from July 2011 to December 2020 was performed. The patients were divided into VI positive group ( n=213) and VI negative group ( n=83) based on pathological results. The data were divided into training set ( n=207) and test set ( n=89) according to the ratio of 7∶3 with stratification sampling. The clinical characteristics of patients were recorded, and the independent risk factors of gastric cancer VI were screened by multivariate logistic regression. Pyradiomics software was used to extract radiomic features from the venous phase enhanced CT images, and the minimum absolute shrinkage and selection algorithm (LASSO) was used to screen the features, obtain the optimal feature subset, and establish the radiomics signature. Four machine learning algorithms, including extreme gradient boosting (XGBoost), logistic, naive Bayes (GNB), and support vector machine (SVM) models, were used to build prediction models for the radiomics signature and the screened clinical independent risk factors. The efficacy of the model in predicting gastric cancer VI was evaluated by the receiver operating characteristic curve. Results:The degree of differentiation (OR=13.651, 95%CI 7.265-25.650, P=0.003), Lauren′s classification (OR=1.349, 95%CI 1.011-1.799, P=0.042) and CA199 (OR=1.796, 95%CI 1.406-2.186, P=0.044) were independent risk factors for predicting the VI of locally advanced gastric cancer. Based on the venous phase enhanced CT images, 864 quantitative features were extracted, and 18 best constructed radiomics signature were selected by LASSO. In the training set, the area under the curve (AUC) of XGBoost, logistic, GNB and SVM models for predicting gastric cancer VI were 0.914 (95%CI 0.875-0.953), 0.897 (95%CI 0.853-0.940), 0.880 (95%CI 0.832-0.928) and 0.814 (95%CI 0.755-0.873), respectively, and in the test set were 0.870 (95%CI 0.769-0.971), 0.877 (95%CI 0.788-0.964), 0.859 (95%CI 0.755-0.961) and 0.773 (95%CI 0.647-0.898). The logistic model had the largest AUC in the test set. Conclusions:The machine learning model based on the venous phase enhanced CT radiomics features has high efficacy in predicting the VI of locally advanced gastric cancer before the operation, and the logistic model demonstrates the best diagnostic efficacy.
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Objective To analyze the risk factors of blood vessel invasion in stage Ⅰ non-small cell lung cancer (NSCLC).Methods A retrospective analysis of 166 patients with stage Ⅰ NSCLC who underwent surgical resection and pathological diagnosis from January 2016 to March 2018 in China-Japan Friendship Hospital was conducted.The presence of blood vessel invasion in tumor tissue was detected by immunohistochemistry.Clinicopathological factors which may affect blood vessel invasion were evaluated by univariate analysis and multiple logistic regression analysis.For statistically significant factors revealed by multivariate analysis,the diagnostic efficiency and best cut-off point were calculated by the receiver operating characteristic curve.Results The univariate analysis identified that the smoking history (P =0.020),maximum standardized uptake value (SUVmax) (P =0.001),tumor diameter (P =0.001),TNM stage (P =0.002),and lymphatic invasion (P =0.023) were factors affecting blood vessel invasion status.Multivariate analysis showed that SUVmax was an independent risk factor for blood vessel invasion (OR =1.097,95 ％ CI 1.014-1.187,P =0.021).The preoperative SUVmax of primary tumor was a predictor for blood vessel invasion with the highest diagnostic accuracy at a cut-off value of 4.85,the sensitivity and specificity were 66.0 ％ and 71.7 ％,respectively.Conclusion The SUVmax is an independent predictor for blood vessel invasion in stage Ⅰ NSCLC,and the risk of blood vessel invasion rises with the increase of SUVmax.
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Background and purpose:Visceral pleural invasion (VPI) and vessel invasion (VI) are poor prognostic factors in patients with non-small cell lung cancer (NSCLC). The primary initial recurrence site may be local recurrence in VPI and distant metastasis in VI. The purpose of this study was to validate the prognostic impact and effect of the initial recurrence site of VPI and VI on survival outcomes for NSCLC.Methods:Two hundred and ninety patients who were diagnosed as having NSCLC and underwent lobectomy between Jan. 2007 and Dec. 2013 were retrospectively analyzed. VPI was identiifed in 51 patients as VPI group, the other 239 patients without VPI as non-VPI group. VI was identiifed in 29 patients as VI group, the other 261 patients without VI as non-VI group. Clinical characteristics, overall survival (OS), disease-free survival (DFS) were compared.Results:There were statistically signiifcant differences between VPI group and non-VPI group in tumor size, lymph node metastasis, TNM stage and initial recurrence site (P 72.3%,P=0.001). Cox regression showed TNM stage was a significant prognostic factor for DFS, whereas lymph node metastasis and VPI were signiifcant prognostic factors in patients with NSCLC.Conclusion:The primary initial recurrence site in VPI patients is local recurrence. Patients with VPI or VI may need more postoperative therapy because of their poor prognosis.
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Objective To analyse the relationship between lymphatic vessels invasion and clinical pathological features of papillary thyroid carcinoma ( PTC ) .Methods The expressions of D2-40 and CK19 were examined in the 104 specimens of PTC using immunohistochemical staining with combined monoclonal antibodies and cocktail double enzyme labeled antibody( D2-40/CK19) stainings.The two methods were compared in the diagnosis of PTC metastasis, and the factors affecting lymphatic vessels formation were analyzed.Results The positive rate of lymphatic vessels invasion was 37.5%(39/104) by using immunohistochemical staining with combined monoclonal antibodies and 53.8%( 56/104 ) by cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining ( P<0.05).The lymph node metastasis rate was 83.9%(47/56) in the group with lymphatic vessels invasion, significantly higher than that without invasion 22.9%(11/48, P<0.01).The age of patients, diameter of primary tumor were the influence factors of lymphatic vessels invasion in PTC patients(P<0.05 and P=0.063).Conclusion Cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining is a better method to detect lymphatic vessels invasion in PTC than immunohistochemical staining with combined monoclonal antibodies.
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Objective To investigate the relationship between blood vessel invasion (BVI) and clinicopathologic features and prognosis in patients with gastric cancer,and analyze related factors affecting the prognosis of patients.Methods The clinicopathological data of 206 patients with gastric cancer who were admitted to the Nanjing Hospital Affiliated to Nanjing Medical University from January 2007 to December 2010 were retrospectively analyzed.The BVI of surgical tumor specimens in all patients was detected by immunohistochemical staininng.All the patients were followed up via outpatient examination and telephone interview up to March 2014.The count data were analyzed using the chi-square test.The survival curve was drawn by Kaplan-Meier method.The survival analysis and univariate analysis were done using the Log-rank test,and multivariate analysis was done using the COX regression model.Results The BVI rate of 206 patients was 27.67％ (57/206).The BVI rate of tumor tissues,tumor differentiation,perineural invasion,T stage,N stage and TNM stage in all patients with gastric cancer were compared,showing significant differences (x2=14.396,9.569,15.579,43.453,30.732,P ＜ 0.05).After operation,188 patients were followed up for 6.0-60.0 months (median,34.0 months),with the follow-up rate of 91.26％ (188/206).Among 188 patients with follow-up,the median survival time and 5-year cumulative survival rate in patients with BVI and with negative BVI were 32.4 months and 19.6％,40.7 months and 42.0％,respectively,with a significant difference in the survival of patients (x2 =9.364,P ＜ 0.05).The results of univariate analysis showed that the diameter of tumor,tumor differentiation,perineural invasion,BVI,T stage,N stage and TNM stage were factors affecting the prognosis of patients with gastric cancer (x2=9.241,17.486,11.243,9.364,27.666,216.745,49.887,P ＜ 0.05).The results of multivariate analysis showed that the diameter of tumormore than 5 cm,BVI,stage T4,stage N3 and stage Ⅲ were independent risk factors affecting the prognosis of patients with gastric cancer (HR =0.502,0.456,0.052,0.001,0.735; 95％ confidence interval:0.334-0.754,0.289-0.720,0.004-0.664,0.000-0.006,0.159-3.398,P ＜ 0.05).Conclusions BVI in patients with gastric cancer is associated with the progression of tumors.The diameter of tumor more than 5cm,BVI,stage T4,stage N3 and stage Ⅲ are independent risk factors affecting the prognosis of patients with gastric cancer,and BVI may be a predictor of poor prognosis of patients with gastric cancer.
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PURPOSE: We evaluated treatment outcomes of thymic carcinomas to determine prognostic factors for survival. MATERIALS AND METHODS: Between May 1988 and May 2009, 41 patients had pathologic diagnosis of thymic carcinoma in Seoul National University Hospital, Seoul, Korea. Of these, 40 patients were followed up to 188 months after treatment. The mean age of all patients was 58.3 years and male to female ratio was 23 to 17. RESULTS: Among 30 patients who underwent surgical resection, 26 achieved R0 resection and postoperative radiotherapy (PORT) was performed in 22 patients (73%). Various chemotherapeutic regimens were given with local treatment modalities, surgery and/or radiotherapy, in 12 patients. The 5-year locoregional control (LRC), distant metastasis-free survival, progression-free survival (PFS), and overall survival were 79.4%, 53.0%, 42.6%, and 63.6%, respectively. Patients with Masaoka stage I or II showed excellent prognosis of 5-year PFS around 90%. In advanced stages, invasion of the great vessels or atrium by thymic carcinomas was negative prognostic factor for PFS in univariate analysis. Lymph node involvement was statistically significant factor for LRC and PFS. Local or regional recurrence was infrequent after surgical resection followed by PORT, while distant metastasis was the major component of treatment failure. CONCLUSION: Complete resection followed by PORT provided remarkable local control without severe acute toxicities in patients with stage II and favorable stage III thymic carcinoma. Invasion of the great vessels or atrium was statistically significant prognostic factor for PFS.
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Female , Humans , Male , Disease-Free Survival , Korea , Lymph Nodes , Neoplasm Metastasis , Prognosis , Recurrence , ThymomaABSTRACT
Tumor invasion of the vessels displays both therapeutic and prognostic implications and represents a challenge for head and neck surgeons. Although previous research has shown that ultrasound can detect such invasions, accurate sonographic parameters to do so have not yet been established. We sought to determine sonographic criteria which are able to characterize these invasions. A high-resolution transducer was used to perform ultrasound examinations of 15 patients selected from a group with inconclusive radiography and computed tomography diagnosis. We found that encasement of the vessel, tumor immobility or fixation in the vessel wall, and narrowing and/or deformity of the lumen were the best criteria. Indeed, when loss of hyperechoic interface of the vessel wall was used as a single criterion it generated false positive results. This study shows that a combination of parameters can be used to provide the best sensitivity and specificity values to produce conclusive diagnosis of vessel invasion by tumors in the cervical region.
Determinaram-se critérios ultrassonográficos capazes de caracterizar a invasão vascular por tumores em cães. Utilizaram-se transdutores de alta resolução para os exames ultrassonográficos realizados em 15 pacientes, selecionados de um grupo submetido previamente à radiografia e tomografia computadorizada, com resultados inconclusivos. Os melhores critérios encontrados foram: encarceramento do vaso, imobilidade do tumor ou aderência na parede vascular e estreitamento ou deformidade luminal. A perda de definição da interface hiperecoica da parede vascular quando foi usada como critério isolado produziu resultados falso positivos. O estudo demonstrou que uma combinação de parâmetros pode ser usada para aumentar a sensibilidade e especificidade diagnóstica, produzindo diagnósticos mais conclusivos e precisos pra definir a invasão vascular por tumores na região cervical ventral.
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Animals , Dogs , Vascular Neoplasms/diagnosis , Vascular Neoplasms/veterinary , Ventral Thalamic Nuclei , Dogs/metabolism , Radiography/veterinary , Tomography, X-Ray Computed/veterinary , Ultrasonography/veterinaryABSTRACT
The present study evaluated the expression of hepcidin mRNA in hepatocellular carcinoma (HCC).Samples of cancerous and non-cancerous liver tissue were taken from 40 patients with HCC who underwent hepatectomy. Expression of hepcidin mRNA was evaluated by real-time PCR, and compared in tumors differing in their degree of differentiation, number of tumors, and vessel invasion. Hepcidin mRNA expression is uniformly suppressed in HCC. Hepcidin mRNA expression in noncancerous and cancerous tissues was 1991.8 (35.3–25187.4) and 62.6 (1.9–3185.8), respectively (P < 0.0001). There were no significant differences in hepcidin expression among tumors differing in their degree of differentiation, number of tumors, or vessel invasion.
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Objective To explore the predictive value of microvessel density(MVD)and blood vessel invasion(BVI)in hepatic metastasis from early-stage rectal cancer.Methods MVD and BVI in the tumor tissue from 380 patients with stage I and II rectal cancer was determined by immunohistochemical S-P method with anti-CDIOS antibody and anti-CD34 antibody,respectively.Multinomial logistic regression was performed to analyze the predictive value of MVD and BVI in hepatic metastasis from early-stage rectal cancer.Results CD105 was expressed in newborn blood vessels,not in normal blood veseels.in the rectal cancer tissue.MVD was correlated with histological type and infiltration depth(P＜0.05).Besides histological type and infiltration depth,BVI was also correlated with histological grade.Multivariate analysis revealed that histological type,tumor infiltration depth,BVI,adjuvant therapy,and MDV were independent predictors of hepatic metastasis from rectal cancer.The risk of hepatic metastasis in patients with postive expression of either MVD or BVI or both were significant higher than that in patients with low expression of MVD and those without BVI expression[hazard ratio(95%CI),4.210(2.182-11.214)].Conclusion BVI and MVD are independent predictors of hepatic metastasis from stage I and II rectal cancer.Combined detection of MVD and BVI may help to predict the clinical outcome of patients with early-stage rectal cancer.
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Objective To investigate the expression of Foxp3~+ lymphocytes in breast carcinoma tissues and their correlation with other pathological factors,and to investigate the mechanism of action of Treg cells.Methods The expression of Foxp3~+ lymphocytes in the breast cancer tissue and non-cancerous tissue was detected by flow cytometry (FCM) in 30 breast carcinoma patients, and its correlation with other pathological factors was statistically analyzed by multiple linear regression analysis.The expression of TGF-β and IL-10 in the lymphocytes infiltrated in breast cancer tissue and non-cancerous tissue was measured by immunohistochemistry, and their correlation with the expression of Foxp3~+ lymphocytes was statistically analyzed by linear correlation dependability analysis. Results There was significant difference in the expression of Foxp3~+ lymphocytes between the malignant and non-cancerous breast tissues(P<0.05),and it was positively correlated with the clinical stage,blood vessel invasion and the matter of axillary lymph node metastasis(P<0.05). The expression of IL-10 in the tumor infiltrating lymphocytes was positively correlated with the expression of Foxp3~+ lymphocytes(P<0.05).Conclusion The expression level of Foxp3~+ lymphocytes is correlated with invasion and metastasis of breast carcinoma, and the IL-10 secreted by Foxp3~+ lymphocytes may be involved in this effect.Foxp3~+ lymphocytes can be used as an assistant marker for prediction and new therpeutic target of breast cancer.
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Objetivos: Detectar a presença de invasão vascular nas biópsias por agulha grossa de carcinoma demama por meio da técnica IHQ (IHQ) com duplo marcador (CD34-pancitoqueratina AE1/AE3);analisar a sensibilidade, a especificidade, o valor preditivo positivo (VPP) e o valor preditivo negativo(VPN) com essa técnica e comparar a acurácia do duplo marcador com a técnica da hematoxilinaeosina(H&E). Métodos: Cortes histológicos de 74 casos de biópsias por agulha grossa de pacientescom câncer de mama foram submetidos à coloração por IHQ com duplo marcador e coloração porH&E. Como grupo-controle, utilizou-se os resultados anatomopatológicos das cirurgias. Resultados:Invasão vascular ocorreu em 34 casos (45,9%). O teste H&E demonstrou valores superiores à IHQquanto a sensibilidade, especificidade, VPP e VPN. Apenas em casos sem metástases axilares, a especificidadefoi superior no teste com IHQ. Conclusão: O teste com maior acurácia para a detecção deinvasão vascular nas biópsias foi o da coloração por H&E. Nos casos sem metástases axilares, o duplomarcador mostrou-se superior somente quanto à especificidade. Por causa da escassez de material dasbiópsias, a principal suposição é que, no material proveniente das cirurgias, que é mais representativo,ou em biópsias com maior número de fragmentos, o duplo marcador tenha melhores resultados.
Purposes: To detect blood vessel invasion in breast cancer core-biopsies through the immunohistochemicaldouble staining technique (CD34 and pancytokeratin AE1/AE3); to analyze the sensitivity, specificity, positivepredictive value and negative predictive value of this technique and to compare the accuracy of double stainingwith the hematoxylin-eosin technique. Methods: 74 specimens of breast cancer core-biopsies were analyzed.Core-biopsy specimens were stained with immunohistochemical (IHC) double staining and with hematoxylineosin(H&E) in different slides for blood vessel invasion research. For the control group, we used anatomopathologicalresults from previous surgeries. Results: 34 patients (45.9%) presented blood vessel invasion. The H&Etest showed better results of sensitivity, specificity, positive predictive value (PPV) and negative predictive value(NPV). Only in cases without metastatic axillary lymph node, specificity was higher in the ICH test. Conclusion:The H&E is the most accurate method to the detection of blood invasion in core-biopsies breast cancer. Incases without metastatic axillary lymph node, IHC double staining proved to be superior regarding specificity.Considering the low density of core-biopsy specimens, our hypothesis is that IHC double staining would be thebest choice when used in specimens of surgeries or in core-biopsy with abundant sample of tissue.
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Humans , Female , Biopsy, Needle/methods , Carcinoma/diagnosis , Carcinoma/blood supply , Breast Neoplasms/diagnosis , Breast Neoplasms/prevention & control , Eosine Yellowish-(YS) , Hematoxylin , Immunohistochemistry , Predictive Value of TestsABSTRACT
PURPOSE: In this study we evaluated the significance of false positive screening bone scintigraphy (BS) in primary invasive breast cancer patients. Lymphatic vessel invasion (LVI), estrogen receptor (ER), progesterone receptor (PR), nuclear grade, histology grade, epidermal growth factor receptor (EGFR) and C-erb-B2 values were examined in terms of their abilities to predict the accuracy of abnormal BS. We also examined the incidence of bone metastasis in primary invasive breast cancer patients according to the 1988 and 2003 AJCC classifications. METHODS: A retrospective review was performed on 2,044 primary invasive breast cancer patients that had received BS screening, and who were treated by mastectomy or breast conserving surgery at the Seoul National University Hospital between Jan 1995 and Jul 2003. Abnormal screening BS results were divided into "less suspicious" and "highly suspicious" groups. Patient's stages according to the 1988 AJCC classification were reclassified according to the 2003 AJCC classification. Bone metastasis was confirmed by further radiological examination or follow-up BS. All statistical analyses were two-tailed. RESULTS: The incidences of bone metastasis and an abnormal screening BS result were 1.7% (35/2,044) and 13.8% (283/2,044), respectively. The false positive rate of screening BS was 87.6% (248/283). LVI was the only significant predictive factor of bone metastasis in 283 of the abnormal BS patients (p <.001). c-erb-B2 showed no significance to predict bone metastasis in the "less suspicious" group, but was Bone is the most common site of distant metastasis in invasive breast cancer at the time of primary diagnosis. The vertebrae are the most common sites of bone metastasis and the ribs, skull, sternum and proximal long bones are also frequently involved. Bone metastases affect 8% of patients marginally significant in the "highly suspicious" group (p = .046). ER, PR, nuclear grade, histology grade, and EGFR showed no significance in terms of predicting the accuracy of an abnormal BS result. The incidences of bone metastasis were 0.6, 1.3 and 7.6% in stages I, II and III, respectively, according to the 1988 AJCC classification, while these incidences were 0.6, 0.7 and 5.8% according to the 2003 AJCC classification. CONCLUSION: The use of screening bone scintigraphy as a routine screening test is hard to justify due to its high false positive rate. LVI may be a useful factor in that it predicts the accuracy of an abnormal BS result. The incidences of bone metastasis in stages II and III were lower for the 2003 AJCC staging system.
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Humans , Breast Neoplasms , Breast , Classification , Diagnosis , Estrogens , Follow-Up Studies , Incidence , Lymphatic Vessels , Mass Screening , Mastectomy , Mastectomy, Segmental , Neoplasm Metastasis , Radionuclide Imaging , ErbB Receptors , Receptors, Progesterone , Retrospective Studies , Ribs , Seoul , Skull , Spine , SternumABSTRACT
The authors report a very unusual case of ruptured aneurysm by direct vessel invasion of anaplastic oligodendroglioma (WHO grade III) confirmed by histopathological examinations. As local invasion is the hallmark of malignant gliomas, malignant glial tumors invade neighboring structure and often cause microscopic endothelial proliferation, telangiectasias in small arteriols, but direct arterial invasion by glioma is very rare. Possible mechanisms of intracranial aneurysm development by glioma are thought to be related to the close proximity to the tumor, perivascular basement membrane breakage due to high tumor pressure and increased regional blood flow through the feeding artery of tumor. The aneurysm and tumor were treated in a single operation simultaneously.
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Aneurysm , Aneurysm, Ruptured , Anterior Cerebral Artery , Arteries , Basement Membrane , Glioma , Intracranial Aneurysm , Oligodendroglioma , Regional Blood Flow , Rupture , TelangiectasisABSTRACT
Objective To investigate the characteristics and clinicopathologic significance of microlymphatic vessel in breast cancer.Methods The microlymphatic density(MLD)and lymphatic vessel invasion(LVI)in 102 cases of breast cancer tissue were evaluated by immunohistochemical staining,using monoclonal antibody for podo- planin.The characteristic of microlymphatic vessel and the relationship between MLD,LVI and clinicopathological parameters were evaluated.And blood vessels were also detected with CD34 by double-labeling immunohistochemis- try for confirming the specificity of podoplanin for microlymphatic vascular.Results Podoplanin antibody was spe- cific for lymphatic vessel without intersection with blood vessel.The density and morphology of microlymphatic ves- sel in breast cancer had significant heterogeneity.The MLD in breast cancer tissues was significantly higher than that in normal breast tissues.The microlymphatic vessel that in breast cancer tissues indicated by a more irregular shape and a larger open lumen,and some cancer embolus entering the open microlymphatic vessel could be seen. MLD was significantly correlated with LVI(P
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PURPOSE: Various types of minimally invasive therapy have been attempted for early gastric cancer (EGC) patients. However, minimally invasive therapy can not fully evaluate the nodal status which has been suggested as an important prognostic factor for EGC patients. This study was conducted to evaluate the clinical implications and prognostic impact of lymphatic or blood vessel invasion (LBVI) in EGC patients in the era of minimally invasive therapy. METHODS: A total of 566 EGC patients who had undergone gastrectomy with D2 or more extended lymphadenectomy between July 1993 and December 1997 were retrospectively reviewed. The risk factors that determine LBVI and the clinicopathological features, recurrence rates, and prognoses according to LBVI were investigated by univariate and multivariate analyses. RESULTS: Lymphatic vessel invasion was noted in 59 patients (10.4%); blood vessel invasion in 13 patients (2.3%); LBVI in 61 patients (10.8%). LBVI was associated with submucosal invasion, larger tumor size, and elevated macroscopic type (P<0.05). LBVI and lymph node metastasis were found to be significantly correlated. LBVI was an independent risk factor for lymph node metastasis (relative risk 26.56, 95% confidence interval 12.77-55.23). Patients with LBVI had a recurrence rate of 15.3% while patients without LBVI had a 3.7% recurrence rate (P<0.01). The overall and disease-specific 5-year survival rates were 79.9 and 85.9% for patients with LBVI whereas they were 93.4 and 97.5% for patients without LBVI (P<0.01, respectively). On multivariate analysis, LBVI was an independent risk factor for poor prognosis (relative risk 2.38, 95% confidence interval 1.15-4.93). CONCLUSION: Lymphatic or blood vessel invasion is an adverse prognostic indicator for EGC patients. Considering the low rate of lymph node metastasis and recurrence in patients with LBVI negative EGC, minimally invasive therapy can be regarded as curative when LBVI is negative.
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Humans , Blood Vessels , Gastrectomy , Lymph Node Excision , Lymph Nodes , Lymphatic Vessels , Multivariate Analysis , Neoplasm Metastasis , Prognosis , Recurrence , Retrospective Studies , Risk Factors , Stomach Neoplasms , Survival RateABSTRACT
PURPOSE: The vessel invasion by cancer cells can be easily detected with the photomicroscope, but still there is an arguement on the value as a prognostic factor. The following study was conducted to evaluate the clinicopathologic significance of blood vessel invasion (BVI) and lymphatic vessel invasion (LVI) as a potential prognostic factor in gastric cancer treatment. MATERIALS AND METHODS: 618 patients who had undergone gastrectomies for gastric cancer at the Department of Surgery, Yonsei University College of Medicine, from August, 1993 to December, 1994, were retrospectively reviewed. Patients, based on the presence of BVI and/or LVI by HE stain, were arranged into three groups: Group 1 (n=338) consisted of patients with no evidence of BVI and LVI; group 2 (n=224), with evidence of either BVI or LVI; group 3 (n=56), with evidence of both BVI and LVI. The clinicopathologic features were analyzed and the survival rates of BVI, LVI and the three groups were studied. RESULTS: BVI-positive patients were seen in 10.5% of all patients, and LVI-positive, in 43.9%. Certain factors such as tumor size, gross type, depth of invasion, lymph node metastasis, distant metastasis, and TNM staging showed significant differences among the three groups by univariate analyses. Survival rates between the BVI-positive (48.1%) and the BVI-negative (73.9%) and between the LVI-positive (55.4%) and the LVI-negative (82.6%) showed significant differences. 3-year survival rates of group 1, 2, and 3 were 82.5%, 59.7%, and 42.0%, respectively, with significant differences. But multivariate analysis demonstrated that distant metastasis, lymph node metastasis, depth of invasion, age, and gross type served as significant prognostic parameters while BVI and LVI did not. CONCLUSION: Patients with BVI and/or LVI were associated with larger tumor size, infiltrative type tumor, deeper gastric wall invasion, more lymph node metastases, and advanced stages of tumor. BVI and LVI also played significantly adverse influence in the survival time in univariate analysis. With further studies on their roles in clinicopathologic features, lymphovascular invasion would be a useful prognostic factor in gastric cancer.