Detection of lymphovascular invasion in vulvar cancer by D2-40 (podoplanin) as a predictor for inguinal lymph node metastases.

Abstract

BACKGROUND:

Lymphatic vessel invasion (LVI) plays a major role in the spread of vulvar cancer and predicts regional lymph node metastasis. D2-40, a monoclonal immunohistochemical marker might be able to increase the detection rate of LVI compared to conventional hematoxylin-eosin (HE) staining. The aim of the study was to evaluate the suitability of D2-40 for the prediction of regional lymph node metastases.

PATIENTS AND METHODS:

Immunohistochemical staining with D2-40 was performed on formalin-fixed, paraffin-embedded tissue sections of 32 patients with squamous cell carcinoma of the vulva. Slides were screened for the presence of LVI. Correlation with clinico-pathological features including LVI as retrieved by routine HE-stained sections was assessed.

RESULTS:

Immunostaining with D2-40 significantly (p = 0.019) increased the frequency of detection of lymphatic invasion compared to conventional HE staining. LVI was correctly identified by D2-40 (D2-40+ LVI) in 65.6% of tumor specimens as compared to 40.6% by routine HE staining (HE+ LVI). D2-40+ LVI significantly (p = 0.026) predicted inguinal lymph node metastases.

CONCLUSIONS:

Immunostaining with D2-40 significantly increased the frequency of detection of lymphatic invasion compared to conventional HE staining in squamous cell carcinomas of the vulva. D2-40+ LVI is a strong predictor for inguinal lymph node metastases.

• Authors: Michael Braun, Eva Wardelmann, Manuel Debald, Gisela Walgenbach-Bruenagel, Tobias Höller, Matthias Wolfgarten, Axel Sauerwald, Christian Rudlowski, Reinhard Büttner, Walther Kuhn, Martin Pölcher
• Journal: Onkologie (Onkologie) Vol. 32 Issue 12 Pg. 732-8 (Dec 2009) ISSN: 1423-0240 [Electronic] Switzerland
• PMID: 20016234 (Publication Type: Journal Article)
• Copyright: Copyright 2009 S. Karger AG, Basel.

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• monoclonal antibody D2-40

Topics

• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal (analysis)
• Antibodies, Monoclonal, Murine-Derived
• Carcinoma, Squamous Cell (pathology, secondary)
• Female
• Groin
• Humans
• Inguinal Canal (pathology)
• Lymphatic Metastasis
• Lymphatic Vessels (pathology)
• Male
• Middle Aged
• Neoplasm Invasiveness (pathology)
• Prognosis
• Reproducibility of Results
• Sensitivity and Specificity
• Vulvar Neoplasms (pathology)