Detection of Lymphatic Invasion in Primary Melanoma With Monoclonal Antibody D2-40

Niakosari, Firouzeh; Kahn, Harriette J.; Marks, Alexander; From, Lynn

doi:10.1001/archderm.141.4.440

Cited by 81 publications

(68 citation statements)

References 15 publications

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“…D2-40 strongly labeled lymphatic endothelial cells, highlighting the presence of lymphatic invasion in the tumors. In our study, D2-40 increased the detection rate of angiolymphatic invasion by 19% over routine H&E. Similar to previous study, 42 we showed a significant correlation between lymphatic invasion detected by D2-40, pT, and lymph node, and liver metastases.…”

Section: Discussionsupporting

confidence: 91%

“…19 D2-40 outlines tumor emboli in lymphatics otherwise indiscernible by H&E, and increases the detection rate of lymphatic invasion by 16% in melanoma patients. 42 The same investigators observed a trend in the association between lymphatic invasion and other prognostic indicators. Our results showed that D2-40 immunostaining is a useful immunohistochemical marker for identifying the presence of lymphatic invasion.…”

Section: Discussionmentioning

confidence: 89%

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Lymphatic microvessel density as prognostic marker in colorectal cancer

et al. 2006

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Lymph node metastases is an important prognostic indicator for disease progression and crucial for therapeutic strategies in the work-up of colorectal carcinoma. In this study, we investigated tumor lymphangiogenesis and vascular endothelial growth factor (VEGF) expression as predictive markers for the risk of lymph node metastasis and their relation to other prognostic parameters in colorectal carcinoma. Resected colorectal carcinomas from 90 patients were examined, including 30 patients without lymph node metastases, 30 with only lymph node metastases, and 30 with liver metastases. Cases were immunostained for CD31, D2-40, and VEGF. Positivity stained microvessels were counted in densely vascular/lymphatic foci (hot spots) at Â 400 field ( ¼ 0.17 mm 2 ). Intensity of staining for VEGF was scored on a two-tiered scale. D2-40 lymphatic microvessel density demonstrated significant correlation with CD31 counts (2079 vs 1876/0.17 mm 2 field, Po0.05) and VEGF expression (Po0.01). VEGF was expressed in 61/90 (67%) cases. D2-40 identified lymphatic tumor invasion in 48/90 patients, which was greater than CD31 (37/90) and hematoxylin and eosin (H&E) (31/90). There was a positive significant correlation of D2-40, CD31 counts, and VEGF expression with the presence of lymphovascular invasion and lymph node metastases (Po0.05). D2-40 lymphatic microvessel density correlated significantly with depth of invasion (pT), positive vascular pedicle lymph nodes and liver metastases (Po0.05). In conclusion, D2-40 lymphatic microvessel density showed prognostic significance with positive correlation with lymphovascular invasion, pT, and metastases to lymph nodes and liver. Immunostaining with D2-40 enhances the detection of lymphatic invasion relative to H&E staining and the endothelial marker, CD31.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 89%

Lymphatic microvessel density as prognostic marker in colorectal cancer

et al. 2006

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“…This Endothelial lymphatic marker D2-40 A Arnaout-Alkarain et al confirmed our previous study that showed the presence of D2-40 þ lymph vessel invasion in breast cancer and other tumors. 34,35 The distinction between lymph vessel and vascular invasion in breast cancer has also been demonstrated using D2-40 and the vascular marker CD34. 36 Furthermore D2-40 has been shown to be the best marker for lymphatic endothelium.…”

Section: Discussionmentioning

confidence: 99%

“…33 We observed that D2-40 identified lymph vessel invasion in paraffinembedded sections of primary carcinomas of breast, colon, prostate, cervix and endometrium as well as melanomas. 34,35 In a pilot study of 50 breast cancers, D2-40 increased the detection of lymph vessel invasion by 20% in node-negative cases and 16% in node-positive cases. 34 Van den Eynden et al's 36 study also showed that D2-40 distinguished lymphatic invasion from blood vessel invasion in breast cancers.…”

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confidence: 99%

Significance of lymph vessel invasion identified by the endothelial lymphatic marker D2-40 in node negative breast cancer

et al. 2007

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Monoclonal antibody D2-40, a marker of lymphatic endothelium, identifies tumor emboli in lymph vessels. The aim of the study was to assess whether D2-40 þ lymph vessel invasion (LVI) correlates with clinicopathologic factors including lymphovascular invasion (LVI) as assessed by haematoxylin and eosin-stained sections (H&E þ or H&EÀ) and to assess the prognostic significance in node-negative breast cancer. The study group consisted of 303 node-negative breast cancer patients that had a median follow-up of 7.6 years. Clinical and pathological data were retrieved from the Henrietta Banting database. Immunohistochemical staining was performed on formalin-fixed, paraffin-embedded tissue sections of the primary invasive carcinoma using D2-40. Immunostaining with CD31 was performed on the discordant cases that were H&E þ /D2-40À. D2-40 þ lymph vessel invasion was detected in 82/303 (27%) cases. The foci of lymphatic invasion occurred predominantly at the invasive front of the tumor. The absence of D2-40 and CD31 in 13/17 discordant cases was suggestive of retraction artefact. D2-40 þ lymph vessel invasion correlated significantly with age (P ¼ 0.0003), tumor size (P ¼ 0.005), histological grade (P ¼ 0.0001), H&E þ (P ¼ o0.0001) and estrogen receptor status (P ¼ 0.005) but not with histological type or progesterone receptor status. Multivariate analysis revealed that D2-40 þ lymph vessel invasion was the only significant predictor of distant recurrence. There was no significant association between D2-40 status and local recurrence (P ¼ 0.752) or regional recurrence (P ¼ 0.13). Both D2-40 þ lymph vessel invasion (P ¼ 0.009) and H&E þ LVI cases (P ¼ 0.02) were associated with overall shorter survival in univariate analysis. These data indicate that D2-40 identifies lymphatic invasion in breast tumors and is a significant predictor of outcome in breast cancer.

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“…O D2-40 é um marcador altamente sensível e específico de endotélio linfático em tecidos normais e num grupo de lesões vasculares, incluindo sarcoma de Kaposi, tumor de Dabska e linfangioma. Esse anticorpo também tem o potencial para aumentar a acurácia na detecção de invasão linfática nos tumores primários (Fukunaga, 2005;Kahn e Marks, 2002;Kahn et al, 2002;Niakosari et al, 2005).…”

Section: Discussionunclassified

Melanomas extensivo-superficiais regressivos e não-regressivos finos: análise da densidade microvascular utilizando-se os marcadores D2-40 e CD31

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Detection of Lymphatic Invasion in Primary Melanoma With Monoclonal Antibody D2-40

Cited by 81 publications

References 15 publications

Lymphatic microvessel density as prognostic marker in colorectal cancer

Lymphatic microvessel density as prognostic marker in colorectal cancer

Significance of lymph vessel invasion identified by the endothelial lymphatic marker D2-40 in node negative breast cancer

Melanomas extensivo-superficiais regressivos e não-regressivos finos: análise da densidade microvascular utilizando-se os marcadores D2-40 e CD31

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