Quantitative Analysis Of Microvascular In Identifying Invasion Depth Of Early Gastric Cancer

Objective:To investigate the changes of capillary pattern with respect to the depth of invasion in early gastric cancer and the role of tumor-associated macrophages(TAMs)in progression and angiogenesis of early gastric cancer.Methods:Archival histological specimens for high-grade intraepithelial neoplasia(HGIN)or early gastric cancer confirmed by pathological diagnosis were selected for review,which were from Liaocheng People’s Hospital,between July 2014 and September 2015.A total of38 samples of early gastric cancer were studied,which included 20 samples of intra-mucosal carcinoma and 18 samples of sub-mucosal carcinoma.Six samples of normal gastric mucosa adjacent to carcinoma were selected as control group.For each of the histological types,the microvessel density(MVD)and vascular diameter at hot spots based on immunostaining for CD31 and CD105 were evaluated respectively.And the areas of TAMs based on immunostaining for CD68 were also estimated.The correlation between MVD or vascular diameter and the depth of invasion of early gastric cancer was analyzed.The relationship between CD68+TAMs and MVD or the clinicopathologic features of early gastric cancer was further investigated.Results:1.Both MVD-CD31 and MVD-CD105 were higher in early gastric cancer than in normal gastric mucosa(t=3.60,P=0.001;t=6.78,P=0.000),however,there were no statis-tically significant difference between intra-mucosal carcinoma and sub-mucosal carcinoma(t=0.60,P=0.56;t=0.91,P=0.38).MVD was lowest for normal gastric mucosa,followed in ascending order by intra-mucosal carcinoma and sub-mucosal carcinoma.And Spearman rank correlation test indicated the correlation was significant but weak for MVD-CD31(r_s=0.351,P=0.019),as well as for MVD-CD105(r_s=0.372,P=0.013).In addition,the correlation was significant and strong between MVD-CD31 and MVD-CD105 by Pearson correlation test(r=0.855,P<0.01).2.Vascular diameter were higher in early gastric cancer than in normal gastric mucosa(t=6.13,P=0.000),but there were no statistically significant difference between intra-mucosal carcinoma and sub-mucosal carcinoma(t=0.13,P=0.90).The diameter of micro-vessels in differentiated-type early gastric cancer were higher than that in undifferentiated-type,and the difference was statistically significant(t=2.52,P=0.02).3.CD68+TAMs were higher in early gastric cancer than in normal gastric mucosa(t=4.59,P=0.000).The areas of CD68+TAMs in sub-mucosal carcinoma were slightly higher than that in intra-mucosal carcinoma,but the difference was no statistically signific-ant(t=0.64,P=0.52).CD68+TAMs in undifferentiated-type were obviously higher than that in differentiated-type(t=5.37,P=0.000);and CD68+TAMs in patients with lymphatic metastasis or lymphovascular invasion were greater than that in patients without lymphatic metastasis and lymphovascular invasion(t=2.88,P=0.007).4.By Pearson correlation test,CD68+TAMs was significantly correlated with MVD-CD105(r=0.467,P=0.001)and with MVD-CD31(r=0.366,P=0.015).Conclusions:1.Microvessel density(MVD)were obviously higher in early gastric cancer,but there was no statistically significant difference in both histological types and invasion depths.2.Vascular diameter were obviously higher in early gastric cancer.There was statistically significant difference in histological types,but no significant difference in the depths of invasion.3.Tumor-associated macrophages(TAMs)was closely related to histological types and lymphatic metastasis,and played an important role in angiogenesis of early gastric cancer.