Significant effects of lymph and blood vascular invasion on the prognosis of early-stage cervical squamous cell carcinoma.
Summary of "Significant effects of lymph and blood vascular invasion on the prognosis of early-stage cervical squamous cell carcinoma."
Aim:  In the past 10 years, therapeutic advances have led to improved short-term efficacy for cervical carcinoma; however, the 5-year survival rate was not significantly enhanced. To investigate the effects of blood vessel invasion (BVI) and lymph vessel invasion (LVI) on the prognosis of early-stage cervical squamous carcinoma, we carried out immunohistochemical staining to distinguish blood and lymph vessels. Methods:  Specimens from 111 IB-stage or IIA-stage cervical squamous carcinoma cases were examined for BVI and LVI by streptavidin-peroxidase immunohistochemistry using CD-34 and D2-40 monoclonal antibodies. Data were analyzed with SPSS version 13.0 (SPSS, Chicago, IL, USA) statistical software. The survival rate and survival curve were derived by using the life table method and the Kaplan-Meier method, respectively. Multivariate prognosis analysis was conducted with Cox regression model, and prognosis was evaluated by measuring overall survival (OS) and progression-free survival (PFS). Results:  BVI/LVI double positivity was an independent prognostic factor for both OS and PFS, whereas lymph node metastasis and surgical margin positivity affected only PFS. Patients inflicted with either BVI or LVI displayed no significant difference in survival time. Lymph-vascular space invasion (LVSI), referring to blood and/or lymph vessel invasion correlated with lymph node metastasis, surgical margin positivity, depth of cervical interstitial invasion, squamous cell carcinoma antigen (SccAg) and age. LVSI was a risk factor for both recurrence (P = 0.013, relative risk 3.060) and death (P = 0.005, relative risk 4.512). Post-operation auxiliary external radiation did not improve survival for LVSI-positive cases. Conclusion:  BVI/LVI double positivity constitutes an independent prognostic factor for early-stage cervical squamous carcinoma.
Affiliation
South China State Key Laboratory of Oncology, Department of Gynecologic Oncology Gynecology Pathology, Cancer Center, Sun Yat-sen University, Guangzhou Department of Obstetrics Gynaecology First People's Hospital, Foshan, Guangdong, China.
Journal Details
This article was published in the following journal.
Name: The journal of obstetrics and gynaecology research
ISSN: 1341-8076
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20846259
- DOI: http://dx.doi.org/10.1111/j.1447-0756.2010.01271.x
Medical and Biotech [MESH] Definitions
Early Diagnosis
Methods to determine in patients the nature of a disease or disorder at its early stage of progression. Generally, early diagnosis improves PROGNOSIS and TREATMENT OUTCOME.
Lymphangioleiomyomatosis
A disease characterized by the progressive invasion of SMOOTH MUSCLE CELLS into the LYMPHATIC VESSELS, and the BLOOD VESSELS. The majority of the cases occur in the LUNGS of women of child-bearing age, eventually blocking the flow of air, blood, and lymph. The common symptom is shortness of breath (DYSPNEA).
Giant Lymph Node Hyperplasia
Large benign, hyperplastic lymph nodes. The more common hyaline vascular subtype is characterized by small hyaline vascular follicles and interfollicular capillary proliferations. Plasma cells are often present and represent another subtype with the plasma cells containing IgM and IMMUNOGLOBULIN A.
Vascular Resistance
The force that opposes the flow of BLOOD through a vascular bed. It is equal to the difference in BLOOD PRESSURE across the vascular bed divided by the CARDIAC OUTPUT.
Endothelium
A layer of epithelium that lines the heart, blood vessels (ENDOTHELIUM, VASCULAR), lymph vessels (ENDOTHELIUM, LYMPHATIC), and the serous cavities of the body.
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