Correlations between vascular invasion, neural structures invasion and microvessel density with clinicopathological parameters in gastric cancer

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Aim: Our objective in conducting this study was to estimate the presence of lymphatic, blood vessel and neural invasion on Hematoxylin & Eosin (H&E) staining and also, the microvessel density detected by immunohistochemistry (MVD), in gastric adenocarcinoma, as well as their relationship with the clinical, pathological and biological characteristics of the tumors. Materials and Methods: To assess the vascular and neural invasion in our study, we included 367 patients diagnosed with gastric cancer. For the immunohistochemical study of MVD, from all cases with gastric carcinoma, we selected 28 patients, 12 patients with gastric biopsy and 16 patients with total gastric resection, which established the TNM stage. All the gastric biopsies and surgical samples were prepared using the paraffin-embedding method and H&E staining and using anti-CD31 and anti-CD34 antibodies for the assessment of intratumoral MVD. Results: The positive blood vessel invasion was associated in a significant way with advanced stages (p <0.01) and high grade carcinomas (p<0.01), while lymphatic invasion was very significant associated only with advanced stage tumors (p < 0.001). Regarding peri- and intraneural invasion, there was a significant matching with the female gender (p < 0.05), advanced stages of disease (p < 0.001), the diffuse type of gastric carcinoma (p <0.05), and with poorly differentiated tumors (p<0.05). There was a close relationship between CD34 MVD and the diffuse type of gastric carcinomas, according to Lauren’s classification (p<0.05), and poorly differentiated tumors (p<0.05). The CD34 MVD values mean was significant correlated with TNM stage, especially III and IV stages (p<0.01). Conclusions: Blood vessel invasion, neural invasion and CD34 MVD play a significant role in tumors biological behavior and they can be used as important prognostic parameters which describes the aggressiveness of gastric carcinomas.

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