The Clinical Prognosis Significance Of Lymphangiogenesis In Renal Clear Cell Carcinoma

Objective: To discuss the correlation between lymphangiogenesis and prognosis in patients with renal clearcell carcinoma by researching expression of D2-40in renal clear cell carcinoma.Methods: A total of60patients diagnosed with renal clear cell carcinoma between January2005andOctober2012at the Department of Urology, First Affiliated Hospital of Shihezi University, were includedin this study. We consulted the patients’ medical records including gender, age, lymph node cleaning, lymphnode metastasis, distant metastasis, tumor T stage and Fuhrman nuclear grade from our record room,readHE section of60patients in our department of pathology, selected both cancer and normal tissue paraffinblocks.The D2-40antibody was used to mark lymphatic vessels of60patient samples with renal clear cellcarcinoma through the method of immunohistochemical stain. Light microscopy was used to determine theperitumoral lymph vessels density（PLVD）and observe the presence of intratumoral lymphatic vessels（ILV）.Correlation between the numbers and clinic pathological factors as well as relation between thenumbers and survival rates of patients was assessed. The SPSS17.0software was used for data statisticalanalysis.Results: Mean PLVD of all research objects was16.89, all research objects were divided into two groups,PLVD16.89and PLVD16.89, to do an analysis between PLVD and clinic pathological factors.The resultsshowed that there was no significant difference between the patients with PLVD below average and thosewith PLVD above average in terms of distant metastasis(P=0.073),lymph node metastasis(P=0.758),Fuhrman nuclear grade (P=0.866), tumour stage(P=0.653). A significant correlation was found betweenthe presence of ILV and distant metastasis(P=0.001),lymph node metastasis(P=0.017)and the Fuhrmannuclear grade(P=0.002). However, no significant correlation was found between the tumour T stage(P=0.570). Survival analysis showed that overall survival rate of group with PLVD above average was50.76%,the median time was52±9months, and below average was63.07%, the median time is71±20months,thesurvival rate of two groups was no significant difference(P=0.223).The overall survival rate of ILV-positivegroup was30.86%, the median time was26±3months, the ILV-negative group was64.36%, the mediantime was71months, extremely significant differences was found between these two groups(P=0.000)。Multiariable Cox regression analysis showed that tumor T stage and ILV were independent prognosticfactors for patients with renal clear cell carcinoma, the P value was0.006and0.001, respectively.Conclusion: D2-40had a high expression level in lymphatic,but didn t express in blood vessels,whichcould clearly distinguish lymphatic and blood vessels.PLVD might be no effect on the prognosis of patientswith renal clear cell carcinoma. The emergence of ILV might be a bad prognosis factor for renal clear cellcarcinoma. Cox regression analysis showed that tumor T stage and ILV were independent prognosticfactors for patients with renal clear cell carcinoma without considering metastasis of lymph node.