Prognostic Value of Lymphangeogenesis and Lymphatic Vessel Invasion 
in Non-small Cell Lung Cancer

Abstract

Background and objective Studies have shown that tumor metastasis in a variety of tumors is associated with lymphangiogenesis and lymphatic vessel invasion (LVI). Tumor metastasis is an important factor that affects the prognosis of patients. The aim of this study is to determine the prognostic value of lymphangiogenesis and LVI in non-small cell lung cancer (NSCLC). Methods We marked the endothelial cells of lymph vessels in lymphangiogenesis with specific monoclonal antibody D2-40. Immunohistochemistry was used to detect the expression of lymphangiogenesis and LVI in 79 cases of stage I-III NSCLC. Results The intratumoral lymphatic vessel density (ITLVD) was significantly higher in patients with N2 disease than those with N0 disease (P=0.015). The ITLVD was significantly higher in patients with LVI+ than that in those with LVI- (P=0.009). The ITLVD was also remarkably higher in poorly differentiated tumors than that in highly differentiated ones (P=0.007). The ITLVD was remarkably higher in adenocarcinoma than that in squamous cell carcinomas (P=0.025). Kaplan-Meier revealed that the survival rates of patients with higher ITLVD were remarkably poorer than those with lower ITLVD (P=0.007). Thus, the ITLVD is an important prognostic factor of NSCLC. The peritumoral lymphatic vessel density is not correlated with the prognosis. Conclusion The ITLVD level is an important prognostic factor of NSCLC.

Keywords

• Lung neoplasms
• Lymphangiogenesis
• Lymphatic vessel invasion
• Prognosis