The role of microvessel density, lymph node metastasis, and tumor size as prognostic factors of distant metastasis in colorectal cancer

Cho,Tomonari; Shiozawa,Eisuke; Urushibara,Fumihiko; Arai,Nana; Funaki,Toshitaka; Takehara,Yusuke; Tazawa,Sakiko; Misawa,Masashi; Homma,Mayumi; Norose,Tomoko; Omatsu,Mutsuko; Miyachi,Hideyuki; Yamochi,Toshiko; Kunimura,Toshiaki; Tate,Genshu; Ishida,Fumio; Kudo,Shin‑Ei; Takimoto,Masahumi

doi:10.3892/ol.2017.5959

The role of microvessel density, lymph node metastasis, and tumor size as prognostic factors of distant metastasis in colorectal cancer

Authors:
- Tomonari Cho
- Eisuke Shiozawa
- Fumihiko Urushibara
- Nana Arai
- Toshitaka Funaki
- Yusuke Takehara
- Sakiko Tazawa
- Masashi Misawa
- Mayumi Homma
- Tomoko Norose
- Mutsuko Omatsu
- Hideyuki Miyachi
- Toshiko Yamochi
- Toshiaki Kunimura
- Genshu Tate
- Fumio Ishida
- Shin‑Ei Kudo
- Masahumi Takimoto
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Affiliations: Department of Pathology and Laboratory Medicine, Showa University School of Medicine, Shinagawa‑ku, Tokyo 142‑8555, Japan, Digestive Disease Center, Showa University Northern Yokohama Hospital, Tsuzuki‑ku, Yokohama 224‑8503, Japan, Department of Clinico‑Diagnostic Pathology, Showa University Northern Yokohama Hospital, Tsuzuki‑ku, Yokohama 224‑8503, Japan
Published online on: March 31, 2017 https://doi.org/10.3892/ol.2017.5959
Pages: 4327-4333

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Abstract

Angiogenesis is essential for tumor growth and metastasis. CD105 is reportedly a specific marker for tumor angiogenesis. It has been demonstrated that monoclonal antibodies to CD105 have high affinity for activated endothelial cells. A relationship between metastasis and microvessel density (MVD), as an indicator of neovascularization, has been identified in patients with colorectal cancer as shown by the presence of monoclonal antibodies to CD105. However, data on potentially confounding factors such as lymphatic and vascular infiltration and tumor size are lacking. We further investigated the relationship between MVD and distant metastasis, along with potentially confounding clinicopathological factors, to more precisely characterize this relationship. In this retrospective study, we analyzed colorectal cancer specimens surgically or endoscopically resected from January to September 2009. We defined MVD as the number of microvessels stained by monoclonal antibodies to CD105 per x400 field. Selected clinicopathological factors were analyzed and stepwise multivariate logistic regression was performed to identify independent risk factors for distant metastasis. We analyzed 129 lesions. The median follow‑up time was 34 months (range, 6‑85 months) in patients with distant metastasis and 61 months (range, 60‑86 months) in those without distant metastasis. At the time of resection or during subsequent follow‑up, 32 patients had distant metastases. The MVD was significantly greater in patients with than without distant metastases (mean ± standard deviation: 10.4±4.9 vs. 7.6±3.3, P=0.008; Welch's t‑test). Stepwise multivariate logistic regression indicated that MVD, regional lymph node metastasis, and tumor size were independent risk factors for distant metastases. Combining assessment of monoclonal antibodies to CD105‑positive MVD with assessment of regional lymph node metastasis and tumor size may help to identify patients who need more intensive surveillance after surgery for colorectal cancer.

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