The role of intratumoral lymphovascular density in distinguishing primary from secondary mucinous ovarian tumors

Abstract

OBJECTIVE:Ovarian mucinous metastases commonly present as the first sign of the disease and are capable of simulating primary tumors. Our aim was to investigate the role of intratumoral lymphatic vascular density together with other surgical-pathological features in distinguishing primary from secondary mucinous ovarian tumors.METHODS:A total of 124 cases of mucinous tumors in the ovary (63 primary and 61 metastatic) were compared according to their clinicopathological features and immunohistochemical profiles. The intratumoral lymphatic vascular density was quantified by counting the number of vessels stained by the D2-40 antibody.RESULTS:Metastases occurred in older patients and were associated with a higher proportion of tumors smaller than 10.0 cm; bilaterality; extensive necrosis; extraovarian extension; increased expression of cytokeratin 20, CDX2, CA19.9 and MUC2; and decreased expression of cytokeratin 7, CA125 and MUC5AC. The lymphatic vascular density was increased among primary tumors. However, after multivariate analysis, the best predictors of a secondary tumor were a size of 10.0 cm or less, bilaterality and cytokeratin 7 negativity. Lack of MUC2 expression was an important factor excluding metastasis.CONCLUSIONS:The higher intratumoral lymphatic vascular density in primary tumors when compared with secondary lesions suggests differences in the microenvironment. However, considering the differential diagnosis, the best discriminator of a secondary tumor is the combination of tumor size, laterality and the pattern of expression of cytokeratin 7 and MUC2.

Podoplanin as Key Player of Tumor Progression and Lymph Vessel Proliferation in Ovarian Cancer

“…Almeida et al demonstrated that the LMVDT is higher in primary mucinous ovarian tumors in comparison to secondary types, but this did not represent a differentiation marker of primary from secondary tumors, as was evidenced in the case of keratin 7 and mucin 2 (MUC2) expression (32).…”

“…Lymphatic microvessel density (LMVD) in ovarian tumors was exclusively quantified with the use of D2-40 (9,10), the lymphatic endothelial cell proliferative index was not taken into consideration. Another aspect with indirect consequences on the evaluation of podoplanin in ovarian tumors is represented by the global evaluation of LMVD.…”

Probing mucin interaction behavior of magnetic nanoparticles

“…This was further indicated from the number of adsorption/binding sites calculated (Table 1). It has been demonstrated that the PEG coated nanoparticles surface reduces the binding with mucin and increases the transport, but it depends on the molecular weight and surface thickness of the PEG [36,40,47,62,63]. In the present study, even though the surface of MNPs+β-CD-F-127 has PEG structures, it showed good binding.…”