Lymphatic vessel density and VEGF-C expression as independent predictors of melanoma metastases

Publication date: Available online 8 July 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Z.Š. Zorica Špirić, Ž.E. Živka Eri, M.E. Mirela Erić
IntroductionIn many patients clinical behaviour of cutaneous melanoma is very difficult to predict by traditional histologic and clinical parameters. The aim of this study was to examine the role of quantitative parameters of tumour lymphangiogenesis and vascular endothelial growth factor (VEGF)-C in predicting metastatic risk in patients with cutaneous melanoma.MethodsOne hundred melanoma specimens were stained with lymphatic-specific antibody D2-40 and with anti-VEGF-C antibody. Quantitative parameters of lymphangiogenesis – lymphatic vessel density (LVD) and lymphatic vessel area (LVA) were determined by computer-assisted morphometric analysis. Moderately or strongly staining was assessed as a positive expression of VEGF-C in tumour cells.ResultsUnivariate analysis revealed that intratumoural LVD, peritumoural LVD, VEGF-C expression in tumour cells, melanoma thickness, Clark level, ulceration, gender, and histologic type were significant predictors of lymph node metastasis (p=0.000, p=0.000, p=0.000, p=0.000, p=0.005, p=0.005, p=0.011 and p=0.027, respectively). No significant association of intratumoural and peritumoural LVA with metastases was found. In multivariate analysis, independent predictors of metastatic risks were melanoma thickness (odds ratio OR=1.655, 95% confidence interval (CI) 1.102-2.484, p=0.015), intratumoural LVD (OR=1.086, 95%CI 1.027-1.148, p=0.004), peritumoural LVD (OR=1.050, 95%CI 1.008-1.094, p=0.020), and a positive VEGF-C expression in tumour cells (OR=20.337, 95%CI 2.579-160.350, p=0.004).ConclusionsThis study identifies intratumoural and peritumoural LVD and VEGF-C expression in tumour cells as a more significant predictors of metastatic risk than melanoma thickness, ulceration and other clinical-pathological parameters.



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