Prognostic Value of Microvessel Density in Tumor and Peritumoral Area as Evaluated by CD31 Protein Expression and Argyrophilic Nucleolar Organizer Region Count in Endothelial Cells in Uterine Leiomyosarcoma

Abstract

The objective of this study was to investigate the prognostic value of microvessel density (MVD) in uterine leiomyosarcoma (LMS) and peritumoral area (PA) as evaluated by CD31 expression and argyrophilic nucleolar organizer region (AgNOR) count in endothelial cells. Tissue specimens from 66 patients with uterine LMS were examined. There were no significant differences in the mean MVD between tumor itself and the PA (P = 0.9); moreover, the MVD in the PA often exceeded that in the tumor. No correlation or significant differences were also found in the MVD between different grades of malignancy of LMS (r = 0.1; P = 0.07). The number of AgNORs in tumor endothelial cells was significantly higher in tumor vessels than in the peritumoral area (P < 0.005) and increased with the tumor grade. Analysis of the prognostic value of MVD in uterine LMS and PA showed that the density of tumor vessels was not an independent criterion, while the MVD in the PA affected 10-year survival to a significantly greater extent (χ 2 = 27.5; P = 0.0003). The number of AgNORs also had an important effect on survival of LMS patients: when the threshold of 11.6 granules was exceeded, prognosis was significantly more unfavorable than that prior to exceeding the threshold.

Prognostic factors in patients with recurrent or metastatic retroperitoneal leiomyosarcoma

“…MVD, as an indicator of neovascularization, has been reported to be associated with invasiveness and a high grade of malignancy in many types of cancer such as breast cancer, prostatic cancer and laryngeal cancer [23][24][25]. In the case of LMS, the relationship between MVD and outcome has been controversial, and previous studies have mostly involved LMS arising from the uterus [26][27][28].…”

Microvessels Density in Uterine Leiomyosarcoma

“…Another research focused on MVD in leiomyosarcoma was conducted on a group of 66 patients by Avdalyan et al [ 5 ]. They used antibodies against CD31 and concluded that MVD in tumor tissue does not affect survival but it does when it is assessed in peritumoral area.…”

“…The process of angiogenesis is crucial for tumors development. To asses MVD in tumors tissues many markers were used, that is, CD34, CD31, CD105, and von Willebrand factor [ 5 – 7 ]. However, it is still not proven which marker is the most suitable for such research.…”

“…In our research no statistical relation between MVD CD34+ and survival parameters was found. This fact combined with positive correlation with poorer prognosis and MVD in peritumoral area reported by Avdalyan et al [ 5 ] may lead to the conclusion that there is a need to investigate other processes that may play an important role in the development of LMS. The role of vascularity in LMS tissue seems to be difficult to define.…”

Angiogenic and lymphangiogenic profiles in histological variants of papillary thyroid carcinoma

“…value (total number of vessels in 3 hot spot microscopic fields/3). 25,26 Single endothelial cells, strips, or clusters of endothelial cells that were positive for CD31 and D2 -40 were considered individual microvessels. Further, the median MVD of the entire group was used to classify patients into 2 subgroups: with high (> median) or low (≤ median) MVD.…”