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    Korean J Urol. 2006 Feb;47(2):111-117. Korean.
    Published online Feb 28, 2006.
    https://doi.org/10.4111/kju.2006.47.2.111
    Copyright © 2006 The Korean Urological Association
    Original Article

    Prognostic Value of Tumor Angiogenesis and Microvascular Invasion in Renal Cell Carcinoma

    Dae Sung Cho, Hyunee Yim,1 Dong Keun Oh, Jin Hun Kang, Young Soo Kim and Se Joong Kim
      • Department of Urology, Ajou University School of Medicine, Suwon, Korea.
      • 1Department of Pathology, Ajou University School of Medicine, Suwon, Korea.
    • Corresponding author (Email: sejoong@ajou.ac.kr )
    Received June 10, 2005; Accepted September 07, 2005.

    Abstract

    Purpose

    This study was performed to evaluate the impact of microvessel density (MVD), a reflection of tumor angiogenesis, and microvascular invasion (MVI) on the prognosis of patients with renal cell carcinoma (RCC).

    Materials and Methods

    Formalin-fixed, paraffin-embedded tissue sections of RCC from 81 patients who had undergone radical nephrectomy were stained immunohistochemically for CD34, which decorate endothelial cells, in order to assess MVD and MVI. The immunostaining results of MVD and MVI were compared with the clinicopathological variables.

    Results

    Twenty-two patients had either synchronous or metachronous metastases and fourteen patients died during the follow-up. MVD was significantly correlated with only metastasis (synchronous or metachronous; p=0.020). MVI was significantly correlated with tumor size (p=0.005), TNM stage (p<0.001), T stage (p<0.001), M stage (p=0.001), and metastasis (synchronous or metachronous; p=0.007). MVD was not significantly associated with MVI (p=0.232). The survival rate of patients with higher MVD or MVI-positive tumors was significantly lower than that of patients with lower MVD or MVI-negative tumors, respectively (p<0.0001, p=0.0002). Multivariate analyses indicated that tumor size, M stage and MVI were independent prognostic factors for cancer-specific survival. MVD was not an independent factor.

    Conclusions

    MVD and MVI were associated with metastasis and a worse prognosis in RCC, which suggests that tumor angiogenesis and MVI may play an important role in the progression of RCC. MVI was an independent prognostic factor for cancer-specific survival.

    Keywords
    Renal cell carcinoma; Prognosis; Veins

    Figures

    Fig. 1
    Immunohistochemical staining for CD34. (A) Endothelial cells of microvessels in renal cell carcinoma are demonstrated by anti-CD34 immunostaining (×200). (B) Note the group of tumor cells surrounded by endothelial cells, which are stained with anti-CD34 antibody (×200).

    Fig. 2
    Kaplan-Meier cancer-specific survival curves according to microvascular invasion (MVI). The survival rate of patients with MVI-positive tumors is significantly lower than that of patients with MVI-negative tumors (p=0.0002).

    Tables

    Table 1
    Clinicopathological data of 81 patients with renal cell carcinoma

    Table 2
    Relationship between microvessel density or microvascular invasion and clinicopathological variables in 81 patients with renal cell carcinoma

    Table 3
    Univariate and multivariate cancer-specific survival analysis of 81 patients with renal cell carcinoma

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    MeSH Terms
    Carcinoma, Renal Cell*
    Endothelial Cells
    Follow-Up Studies
    Humans
    Microvessels
    Multivariate Analysis
    Neoplasm Metastasis
    Nephrectomy
    Prognosis
    Survival Rate
    Veins
    Metrics
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