Background : Although a correlation between microvessel density (MVD) and tumor aggressiveness has been established for several malignancies, the data for renal cell carcinoma (RCC) is conflicting. In order to clarify the significance of MVD, we investigated the relationships between MVD and tumor stage, grade, size, occurrence of metastasis and patient survival. Methods : Tumor specimens from 70 patients with primary renal cell carcinoma were examined by immunohistochemical staining for CD34.Results : There was a tendency for MVD to decrease from G1 to G3 tumors or from stage T1 to T3 tumors, although this was not statistically significant. However, the MVD for 56 non-metastatic and 14 metastatic tumors were significantly different ( P = 0.005) at 109 ± 67 and 58 ± 35 per ¥ 400 field (mean ± SD), respectively. Microvessel density for 36 large and 34 small tumors was also significantly different ( P < 0.0001) at 48 ± 22 and 142 ± 54 per ¥ 400 field, respectively. The survival rate of patients with small, low grade and hypervascular tumors was significantly higher than that of patients with large ( P = 0.0015), high grade ( P = 0.05) or low MVD ( P = 0.039) tumors. Cox proportional hazards regression analysis showed that tumor grade and size emerged as independent prognostic factors. Conclusion : High MVD in RCC was inversely associated with tumor aggressiveness, but MVD was not the independent prognostic factor.
The validity of the sentinel node concept in conjunction with the detection of micrometastases was considered to be high. Furthermore, it was suggested that the efficacy of metastasis diagnosis may also be enhanced, especially in patients receiving neoadjuvant hormone therapy.
TRT by administration of GL is considered to be effective in the improvement of not only ED and LOH symptoms, but also LUTS (especially voiding disturbance) of patients with LOH.
Tadalafil is effective for both male LUTS and ED. It is also shown that tadalafil improves baPWV, which we can conclude that higher vessels elasticity has been obtained. This major finding of this study shows that tadalafil has the potency to improve vessels endothelial dysfunction in patients with BPH.
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