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Impact of microvessel density on lymph node metastasis and survival after curative resection of pancreatic cancer

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Abstract

Purpose

The roles of angiogenesis and the most prominent angiogenic vascular endothelial growth factor (VEGF) in diseases of the pancreas remain controversial. We compared microvessel density (MVD) and VEGF status in normal pancreatic, chronic pancreatic, and pancreatic cancer (PC) tissues to establish their prognostic relevance.

Methods

Eighty samples of PC tissue, 32 samples of normal pancreatic tissue, and 20 samples of chronic pancreatitis (cP) tissue were immunostained with monoclonal anti-CD31 and polyclonal anti-VEGF antibody. The MVD was correlated with clinicopathological features and survival.

Results

Microvessel density was higher in PC than in cP (P < 0.001). Residual tumor status was highly predictive for survival (P < 0.001). After stratification for residual tumor status, we identified lymph node metastasis (LNM) in more than two lymph nodes (P < 0.04) and high MVD (P < 0.03) as risk factors for mortality. Multivariate analysis revealed only a high MVD (P = 0.03, odds ratio 0.441, 95% confidence interval 0.211–0.821) as an independent predictor of poor survival. Vascular endothelial growth factor was found over stromal cells in cP and over ductal adenocarcinoma cells in PC. Vascular endothelial growth factor expression status was not predictive of survival (P < 0.07).

Conclusion

This study confirms the role of angiogenesis in PC and identifies MVD as an independent prognostic factor in patients with curatively resected PC.

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Acknowledgments

We thank Dr Gösta Poch for his expert statistical analysis and valuable comments.

Conflict of interest

C. Benckert and his co-authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany

    Christoph Benckert, Armin Thelen, Gereon Gaebelein, Reinhard Gessner & Sven Jonas

  2. Department of Gastroenterology, Charité, Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

    Thorsten Cramer

  3. Department of Pathology, Charité, Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany

    Wilko Weichert

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  1. Christoph Benckert
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Correspondence to Christoph Benckert.

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Benckert, C., Thelen, A., Cramer, T. et al. Impact of microvessel density on lymph node metastasis and survival after curative resection of pancreatic cancer. Surg Today 42, 169–176 (2012). https://doi.org/10.1007/s00595-011-0045-0

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  • DOI: https://doi.org/10.1007/s00595-011-0045-0

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