The evaluation of lymphatic vessel density and microvessel density in laryngeal squamous cell carcinoma

Yıl 2018, , 57 - 62, 10.06.2018

Ganime Çoban , Ebru Akay , Kemal Deniz İmdat Yüce Süleyman Balkanlı

https://doi.org/10.25000/acem.401204

Öz

Aim: Metastasis to the cervical lymph nodes
in laryngeal carcinomas is a factor reducing survival significantly.  The present study aimed to reveal the
association of lymph node metastasis with lymphatic vessel density and
microvessel density in the intratumoral and extra-tumoral areas of laryngeal squamous
cell carcinoma.

Methods: Eighty-six cases diagnosed with
laryngeal squamous cell carcinoma in Pathology Department of Erciyes University
Faculty of Medicine between 2000-2006 were included in the present study. Lymphatic
vessel density and microvessel density were assessed with D2-40 which is an
immunohistochemical marker in intratumoral and extra-tumoral areas and CD34,
respectively. The results were compared with tumor grade, tumor localization,
and lymph node metastasis.

Results: Intratumoral and extra tumoral lymphatic
vessel density value were 8.93±12.5 and 24.1±20.1, respectively (p=0.001). Mean
intra tumoral microvessel density was calculated as 217.53±89.8 while extra tumoral
microvessel density was calculated as 330.43±92.4 (p=0.001). Intratumoral lymphatic
vessel density value was higher in the well-differentiated tumors compared to
the poorly differentiated tumors but no significant result was obtained (p=0.100).
Extra tumoral microvessel density value was found to be significantly higher in
the poorly differentiated tumors (p=0.05). Intratumoral microvessel density
value was significantly lower in tumors with lymph node metastasis (p=0.028). Extra-tumoral
lymphatic vessel density value was higher in both groups with and without lymph
node metastasis, however, no statistically significant result could be obtained
(p=0.084).

Conclusion: In the present study, intratumoral
microvessel density was higher in well differentiated tumors whereas extra tumoral
microvessel density was determined to be higher in poorly differentiated cases.
No significant association was noted between lymphatic vessel density and
differentiation. Extra tumoral and intra tumoral microvessel density values
were found to be higher in the group without metastasis.  No association was detected between
metastasis and lymphatic vessel density value.

We suggest that assessing lymphatic vessel
density with the co-administration of D2-40 and CD34 may be more important for
early detection of metastasis.

Anahtar Kelimeler

: D2-40, angiogenesis, CD34, larynx, squamous cell carcinoma

Laringeal skuamöz hücreli karsinomlarda lenfatik damar yoğunluğu ve mikrodamar yoğunluğunun değerlendirilmesi

Öz

Amaç: Larinks karsinomlarında boyun lenf
nodlarına metastaz, sağ kalımı önemli oranda azaltan bir etkendir.  Bu çalışmanın amacı; larinksin skuamöz hücreli
tümörlerinde tümör içi ve tümör dışı alanlarda lenfatik damar yoğunluğu ve
mikrodamar yoğunluğunun lenf nodu metastazı ile ilişkisini ortaya koymaktır.

Yöntemler: Çalışmamızda 2000-2006 yılları
arasında Erciyes  Üniversitesi Tıp
Fakültesi Patoloji Ana Bilim Dalı’nda larinks skuamöz hücreli karsinom tanısı
almış 86 olgu incelemeye alındı. Tümör içi ve tümör dışı alanlarda immünhistokimyasal
bir belirteç olan D2-40 ile lenfatik damar yoğunluğu ve CD34 ile mikrodamar
damar yoğunluğu değerlendirildi. Sonuçlar tümör derecesi, tümör yerleşim yeri,
lenf nodu metastazı ile karşılaştırıldı.

Bulgular: Olguların tümör içi ve tümör dışı
lenfatik damar yoğunluğu sırası ile 8,93±12,5  ve 24,1±20,1 idi (p=0,001). Tümör içi
mikrodamar yoğunluğu değeri 217,53±89,8 ve tümör dışı mikrodamar yoğunluğu
değeri 330,43±92,4 olarak sayıldı (p=0,001). İyi diferansiye tümörlerde tümör
içi lenfatik damar yoğunluğu değeri, iyi diferansiye olmayan tümörlere göre
yüksekti, fakat anlamlı sonuç elde edilemedi (p=0,100). Kötü diferansiye
tümörlerde tümör dışı mikrodamar yoğunluğu değeri anlamlı olarak yüksek bulundu
(p=0,050). Tümör içi mikrodamar yoğunluğu değeri lenf nodu metastazı olan
tümörlerde anlamlı olarak düşüktü (p=0,028). Lenf nodu metastazı olan ve
olmayan her iki grupta da tümör dışı lenfatik damar yoğunluğu değeri yüksekti,
istatiksel olarak anlamlı bir sonuç elde edilemedi (p=0,084). Sonuç: Bu
çalışmada iyi diferansiye tümörlerde tümör içi mikrodamar yoğunluğu ve kötü
diferansiye olgularda tümör dışı mikrodamar yoğunluğu daha yüksek idi. Lenfatik
damar yoğunluğu değeri ile diferansiasyon arasında bir ilişki saptanmadı.
Metastaz yapmayan grupta tümör içi ve tümör dışı mikrodamar yoğunluğu değeri yüksek
bulundu.  Metastaz ile lenfatik damar
yoğunluğu değeri arasında bir ilişki izlenmedi.

D2-40 ve CD34 ‘ün birlikte kullanımı ile
lenfatik damar yoğunluğunun değerlendirilmesinin, metastazın erken
belirlenmesinde daha önemli olabileceğini düşünmekteyiz.

Anahtar Kelimeler

D2-40, anjiogenez, CD34, larinks, skuamöz hücreli karsinom

Kaynakça

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