[Angiogenesis and micrometastases of regional lymph node in ovarian cancer]

In many investigation it was demonstrated that intratumor microvessel density (IMD) is the best factor for no tumor survival for patients with ovarian cancer. Occult axillary node micrometastases as the prognostic factor for the patients with breast cancer was proved, but currently no literature of the pelvic lymph node micrometastases in ovarian cancer is provided. This study try to detect the microvessel density of tumor tissues and micrometastases of regional lymph nodes in ovarian cancer and to investigate the relationship between these two factors and their prognostic significance.

The sections of ovarian cancer from 39 patients were stained immunohistochemically for cytokeratin(CK) and factor VIII-related antigen (F8-RA). Microvessels on the section were counted by computerized morphometry (40 fields). Sections of 212 regional lymph nodes from 39 patients were stained also with HE and CK.

(1)We found 7 lymph node metastases with HE staining in 39 patients and 12 micrometastases with CK staining.(2) Average value of intratumor microvessel density (IMD) in the HE positive group was 48.86+/-16.60 and was obviously higher than that in the HE negative group (29.16+/-10.02,P< 0.01). The average IMD was 41.67+/-21.69 in the CK positive group and was also obviously higher than that in the CK negative group (28.70+/-10.77,P< 0.05). We found 8(50%) micrometastases in 16 patients with higher IMD (> or = 30/40 x fields) and only 4(17.4%) micrometastases in 23 patients with lower IMD (< 30/40 x fields), the difference was significant (P< 0.05). (3)IMD (P=0.03) and regional lymph node micrometastases(P=0.04) were the most significant factors to the survival time through Cox proportional hezard model analysis,the IMD (P=0.0008) and clinical stage (P=0.03) were also the most important factors to predict recurrence.

The study suggests the CK immunohistochemical staining could detect the micrometastases in the HE negative lymph node in patients with epithelial ovarian cancer. The IMD is closely related to the micrometastases and these two factors have prognostic significance in ovarian cancer. The IMD and micrometastases could act as independent prognosis factors of patients with ovarian cancer.