Correlation between extent of tumor vascularization, prognosis and hematogenous metastases in gastric carcinoma using vascular endothelial growth factor [VEGF] and Von-Willebrand factor

Angiogenesis has a crucial importance for tumor growth and development of metastasis. This study aimed to evaluate angiogenesis. Microvessel density [MVD] was counted by staining endothelial cells immunohistochemically using anti von Willebrand vWF [factor VIII] antibody as well as vascular endothelial growth factor [VEGF], a known endothelial proliferative and mitogenic marker. Thirty prospective cases [24 cases of adenocarcinoma and 6 of diffuse infiltrating tumors] were enrolled in this study. Then, four cases were excluded from the study because they had inoperable tumors. Thus, a total of 26 patients was studied histologically, immunohistochemically and followed up for a period ranging from 6-30 months [median 12 months]. The immunohistochemical results of these biomarkers were correlated with standard prognostic factors [tumor grade, stage and lymph node metastasis] as well as overall survival period. It was found that MVD was significantly increased in deep advanced tumors and in the presence of nodal metastasis. However, VEGF positivity was demonstrated in only 46% of the cases and was not correlated with the clinicopathologic parameters. The MVD for cases that developed hematogenous metastasis was significantly higher than those having non metastatic tumors. Also, MVD was correlated with a relatively higher survival rates in favor of the hypovascular group

Ultrastructural and immunohistochemical studies of synovial sarcoma [monophasic type]

The present work was carried out on 20 cases of monophasic pattern of synovial sarcoma to speculate on their histogenesis as well as to highlight the important histologic parameters of prognostic value of such tumours. The use of combined immunohistochemistry, as cytokeratin, epithelial membrane antigen [EMA] and vimentin, together with electron microscopy conveyed away the origin of these tumours from the normal synovial lining of joints. The cytokeratins and Epithelial membrane antigen [EMA] were positive epithelial markers in 75% and 45% of the cases respectively, whereas the vimentin mesenchymal marker was positive in 80% of cases. Five negative cases for epithelial markers were examined by electron microscopy, where two cases showed prominent epithelial features in the form of a well defined basal lamina and desmosomal attachments. The other 3 cases were diagnosed as poorly differentiated synovial sarcomas. The histologic features of monophasic pattern with large size tumours of more than 4 cm in diameter showing areas of necrosis exceeding 4mm, with high mitotic rates of more than 15 mitoses / 10 high power fields +/- recurrences or vascular invasion were considered as signs of poor prognosis and unfavorable outcome. There was a significant direct relation between the size of the tumour and the occurrence of recurrences [t = 2.92, P=0.009]. There was also a significant direct relation between the size and the presence of vascular invasion [t=4.54. P