Prognostic value of microvascular density in dukes a and B (t1-t4, n0, m0) colorectal carcinomas

Abstract

Background: Aproximatelly 30% of patients operated on for colorectal cancer (CRC), with an expectedly favourable prognosis (Dukes A-B/T1-T4, N0, M0) suffer recurrence and/or die.

Method: In order to determine if tumor microvascular density (MVD) is a prognostic factor in CRC, samples from tumors of 104 Dukes A-B CRC patients were retrospectively studied. Immunohistochemistry was performed for anti-CD34 antibody to visualize tumor vascularisation. MVD was expressed as the total number of vessels and as the percentage of microvascular area. We calculated MVD with a morphometry program and performed descriptive, bivariate, and survival statistics.

Results: The mean number of vessels was 37.37/200x field, and the mean vascular area was the 3.972%. 30% of the patients with < 37 vessels/field, and 21% of the patients with > 37 vessels/field, experienced recurrence/death. The 35% of patients with < 4% of vascular area died following recurrence, compared with 14% of patients with > or =4% of vascular area. These differences in % of vascular area were statistically significant.

Conclusion: MVD expressed as the total number of vessels had no a statistically significant influence on the evolution of CRC. However, neoplasias with a greater % of vascular were associated to a better outcome.

Figure 1

Low microvascular density foci.

Figure 2

High microvascular density foci.

Figure 3

High MVD in superficial ulcerated area.

Figure 4

Automatic vessel counting with ContImUZ 1.0 morphometry program the whole process.