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10.1245/s10434-006-9201-y
Annals of Surgical Oncology 14:248-257 (2007)
© 2007 Society of Surgical Oncology
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Original Article

Intratumoral Lymphatic Vessels and VEGF-C Expression Are Predictive Factors of Lymph Node Relapse in T1–T4 N0 Laryngopharyngeal Squamous Cell Carcinoma

Adolfo Hinojar-Gutiérrez1, María-Encarnación Fernández-Contreras2, Rocío González-González3, María-Jesús Fernández-Luque3, Adolfo Hinojar-Arzadún1, Miguel Quintanilla4 and Carlos Gamallo2

1 Department of Otorhynolaryngology, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid (UAM), Madrid, Spain
2 Department of Pathology, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid (UAM), Madrid, Spain
3 Department of Methodological Support Unit of the Foundation for Biomedical Research, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid (UAM), Madrid, Spain
4 Department of Cell Signaling. Instituto de Investigaciones Biomédicas "Alberto Sols", Universidad Autónoma de Madrid (UAM), Madrid, Spain

Correspondence: Address correspondence and reprint requests to: Carlos Gamallo, Servicio de Anatomía Patológica, Hospital Universitario de la Princesa, 2a Planta, C/Diego de León, 62, 28006, Madrid, Spain; E-mail: cgamallo.hlpr{at}salud.madrid.org

Background: The presence of intratumoral lymphatic vessels (ILVs) and the expression of vascular endothelial growth factor-C (VEGF-C) in tumour cells have been studied as markers of lymphangiogenesis in order to evaluate their role in metastatic dissemination in laryngopharyngeal squamous cell carcinoma.

Methods: A retrospective study was performed in 76 patients of N0 laryngopharyngeal carcinoma. with variable tumour size (T1–T4), histological grade, and location (supraglottic, glottic and hypopharyngeal). The presence of ILVs, as revealed by the expression of PA2.26 antigen and VEGF-C expression, were determined by immunohistochemistry (IHC). Low-grade and high-grade lymphangiogenesis were defined by qualitative and quantitative criteria.

Results: Multivariate analysis revealed low-grade ILV and VEGF-C expression to be associated respectively with 30.3- and 16.2-fold higher probabilities of cervical lymph node relapse (P = 0.005 and P = 0.032) and with 16.2- and 8.44-fold shorter disease-free survival (P = 0.009 and P = 0.045).

Conclusions: Low-grade ILV and VEGF-C expression are independent predictive factors of cervical lymph node relapse and shortening of time to relapse in N0 laryngopharyngeal carcinoma.

Key Words: VEGF-C • Lymphangiogenesis • Intratumoral lymphatic vessels • Larynx






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