Main Articles

Prognostic value of lymphangiogenesis in supraglottic laryngeal carcinoma

J Y Lin^a1, X Y Li^a2 c1, P Dong^a1 and T Nakashima^a3

^a1 Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiaotong University, China

^a2 Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiaotong University, China

^a3 Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Japan

Abstract

Background: Metastasis to regional lymph nodes via lymphatic microvessels plays a key role in cancer progression, and is an important prognostic factor in many cancers. Recent evidence suggests that tumour lymphangiogenesis promotes lymphatic metastasis.

Aims: To investigate whether tumour lymphatic microvessel density correlates with clinicopathological factors and serves as a prognostic indicator of supraglottic laryngeal carcinoma progression.

Methods: The lymphatics of 84 supraglottic laryngeal carcinoma cases were investigated by immunohistochemical staining for podoplanin (also termed D2-40). The relationships between (intra- and peritumoural) lymphatic microvessel density, clinicopathological parameters and clinical prognosis were analysed.

Results: There was a significant relationship between high intratumoural lymphatic microvessel density and aggressive tumour node stage (p < 0.0001), distant metastasis (p = 0.037) and poor prognosis (p = 0.011), and between high peritumoural lymphatic microvessel density and node stage (p = 0.004) and poor prognosis (p = 0.029). Patients with high lymphatic microvessel density also had significantly worse disease-free survival (p = 0.003) and overall survival (p = 0.005). Intratumoural lymphatic microvessel density was found to be an independent prognostic factor for overall survival (p = 0.008) and disease-free survival (p = 0.005) (multivariate analysis).

Conclusion: Lymphatic microvessel density (detected by podoplanin immunohistochemistry), especially intratumoural density, may be an independent predictor of lymphatic tumour spread and survival in supraglottic laryngeal carcinoma patients, and may be useful to guide decisions regarding additional surgery.

(Accepted January 12 2011)

(Online publication July 21 2011)

Key words

• Lymphangiogenesis;
• Carcinoma, Squamous Cell;
• Otolaryngology;
• Podoplanin Protein, Human;
• Prognosis

Correspondence:

^c1 Address for correspondence: Dr Xiao Yan Li, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiaotong University Affiliated Children's Hospital, 1400 West Beijing Road, Shanghai 200040, People's Republic of China E-mail: tiancheng15@live.cn

Dr X Y Li takes responsibility for the integrity of the content of the paper

Competing interests: None declared