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Tumor Angiogenesis in Lymph Node–Negative Rectal Cancer: Correlation With Clinicopathological Parameters and Prognosis

From the Departments of General Surgery (FC, GP, PB, AT, FP, CC), Human Pathology and Oncology (AP, LM, GA), and Experimental Pathology and Oncology (VB), University of Florence, Florence, Italy.

Correspondence: Address correspondence and reprint requests to: Fabio Cianchi, MD, Sez. Clinica Chirurgica e Terapia Chirurgica, Dipartimento di Area Critica Medica e Chirurgica, Viale Morgagni 85, 50134 Firenze, Italy; Fax: 3955-4220133; E-mail: cianchif{at}mail.unifi.it

Background: Intratumoral microvessel density (MVD) could be used as a prognostic factor in colorectal cancer. We retrospectively analyzed the value of microvessel count in predicting the clinical outcome of stage I and II (Dukes A and B) rectal cancer patients.

Methods: Eighty-four patients who had undergone curative resection of lymph node–negative rectal cancer were included. Tumor type and differentiation, the depth of local invasion, venous invasion, the character of the invasive margin, and the degree of lymphocytic infiltration were evaluated for each tumor specimen. Immunohistochemical staining for the CD31 endothelial antigen was performed to highlight the microvessels.

Results: The median value of MVD was 45 microvessels. Low MVD (microvessels 45) was observed in 41 patients (48.8%), and high MVD (>45) was found in 43 (51.2%). The presence of conspicuous lymphocytic infiltration was significantly associated with increased vessel density. With uni- and multivariate survival analysis MVD did not show any prognostic significance. The character of the invasive margin was the only parameter with independent prognostic value.

Conclusions: MVD does not seem to provide any additional prognostic information when compared with standard histopathological parameters in lymph node–negative rectal cancer. It is likely that the strong association between MVD and the presence of conspicuous lymphocytic infiltration may interfere with its predictive value.

Key Words: Rectal cancer • Angiogenesis • Lymphocytic infiltration • Prognosis

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