Clinical Significance and Regulation of Vascular Involvement in Gastric Carcinoma

Shunichi Tsujitani, Hiroaki Saito, Shinichi Oka, Akira Kondo, Ichiro Konishi, Masahide Ikeguchi, Michio Maeta, Nobuaki Kaibara

Department of Surgery I, Faculty of Medicine, Tottori University

We investigated the clinical significance and regulation of lymphatic involvement and venous involvement in gastric carcinomas. The incidence of both lymphatic involvement and venous involvement in 2,404 patients with gastric carcinoma increased in tandem with tumor progression, such as depth of invasion, size, and lymph node metastasis. Lymphatic and venous involvement was often observed in tumors located in the upper third part of the stomach. Lymphatic involvement was common in solid-type, poorly differentiated carcinomas. Venous involvement was frequent in both solid-and non-solid-type, poorly differentiated carcinoma, and in mucinous carcinoma. Both lymphatic and venous involvement corelated with survival in stage III gastric carcinoma. The expression of vascular endothelial growth factor (VEGF), a potent angiogenesis-promoting factor related to tumor progression, correlated with the incidence of lymphatic and venous involvemen. Infiltration by dendritic cells (DCs), the most potent antigen-presenting cells, was inversely correlated with lymphatic and venous involvement. Serum levels of soluble interleukin 2 receptor (sIL-2R), which is released from activated T lymphocytes into the circulation, also correlated with lymphatic and venous involvement. However, neither VEGF, DCs nor sIL-2R affected the incidence of lymphoid or venous involvement in patients with stage III gastric carcinoma. These results suggest that VEGF, DCs and sIL-2R, in addition to the findings of depth of invasion, size, histologic type, and location of the tumor, may help predict lymphatic and venous involvement in gastric carcinoma.

Key words
gastric cancer, vessel involvement, Angiogenesis

Reprint requests
Shunichi Tsujitani Department of Surgery I, Faculty of Medicine, Tottori University
36-1 Nishi-cho, Yonago, 683-8504 JAPAN

Accepted
July 22, 1998

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