Clinical application of cocktail double enzyme labeled antibody(D2-40/CK19)staining for the diagnosis of lymphatic vessel invasion in papillary thyroid carcinoma / 中华内分泌代谢杂志

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.

The Relationship between Abnormal Screening Bone Scintigraphy and Bone Metastasis in Breast Cancer Patients / 한국유방암학회지

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.

Characteristic and Clinicopathologic Significance of Microlymphatic Vessel in Breast Cancer / 中国普外基础与临床杂志

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

Clinicopathologic Significance of Lymphatic Vessel Invasion and Blood Vessel Invasion in Gastric Cancer / 대한암학회지

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.