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10.1245/s10434-008-0014-z
Annals of Surgical Oncology 15:2581-2588 (2008)
© 2008 Society of Surgical Oncology
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Original Article

Clinical Value of Immunohistochemically Detected Lymphovascular Space Invasion in Early Stage Cervical Carcinoma

Chung Sim Lim, MRCS1, Farhad Alexander-Sefre, MRCOG, MD2, Mohamed Allam, MSc, MRCOG3, Naveena Singh, FRCPath4, Joanne Chin Aleong, FRCPath4, Haytham Al-Rawi, BMedSci, MRCP1 and Ian J. Jacobs, MD, MRCOG5

1 Cancer Research-United Kingdom Translational Oncology Laboratory, St. Bartholomew’s and the Royal London School of Medicine and Dentistry, John Vane Building, Charterhouse Square, London EC1M 6BQ, UK
2 Glasgow Royal Infirmary, Castle Street, Glasgow G4 0SF, UK
3 Wishaw General Hospital, 50 Netherton Street, Wishaw ML2 0DP, UK
4 Department of Pathology, St. Bartholomew’s and the Royal London School of Medicine and Dentistry, London EC1A 7BE, UK
5 Institute for Women’s Health, University College London, Huntley Street, London WC1E 6DH, UK

Correspondence: Address correspondence and reprint requests to: Chung Sim Lim, MRCS; E-mail: cslim{at}doctors.org.uk

Background: This study investigates the clinical significance of lymphovascular space invasion (LVSI) as detected by hematoxylin and eosin (LVSI-H&E) and immunohistochemistry (LVSI-IHC) in early stage cervical carcinoma.

Methods: Single representative sections from 97 patients with early stage squamous cell cervical cancer were immunostained with pan-cytokeratin and CD31 endothelial cell marker antibodies. The H&E sections and their corresponding immunostained sections were reexamined to identify LVSI. Associations between LVSI with clinicopathological factors were sought.

Results: Overall, LVSI was present in 29 (29.9%) and absent in 68 (70.1%) by IHC, as compared with 18 cases (18.6%) and 79 cases (81.4%), respectively, by H&E. Statistical analysis revealed a significant association between LVSI-H&E and nodal metastasis (P = .004). Follow-up data were available for 76 patients. The median follow-up period was 64 months. During follow-up, 7 of 24 patients with recurrent disease had evidence of LVSI-H&E as opposed to 3 of 52 cases with no recurrence. There was a significant association between tumor recurrence and LVSI-H&E (P = .009). The 5-year recurrence-free survival was 30% for the group with LVSI-H&E compared with 73% without. There was a significant difference in the recurrence-free survival between the two groups (P = .002). In contrast LVSI-IHC was found to be associated with no pathological factors, and survival analysis revealed no statistically significant association with recurrence or survival.

Conclusion: LVSI-H&E in early stage cervical cancer remains an important predictive factor of recurrent disease and reduced disease-free interval. Immunohistochemically detected LVSI is a common event and seems to be of no clinical value.

Key Words: Cervical cancer • LVSI • Vascular invasion • Immunohistochemistry






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