Annals of Surgical Oncology

, Volume 14, Issue 2, pp 470–477 | Cite as

Prognostic Significance of Immunohistochemically Detected Blood and Lymphatic Vessel Invasion in Colorectal Carcinoma: Its Impact on Prognosis

  • Pin Liang
  • Ichiro Nakada
  • Jian-Wei Hong
  • Takanobu Tabuchi
  • Gyo Motohashi
  • Akira Takemura
  • Takeshi Nakachi
  • Teruhiko Kasuga
  • Takafumi Tabuchi



The prognostic significance of blood vessel invasion (BVI) and lymphatic vessel invasion (LVI) is unclear. Because of the absence of specific markers for venous and lymphatic vessels, earlier studies could not reliably distinguish between BVI and LVI.


By immunostaining for podoplanin and CD34 antigen, we retrospectively investigated LVI and BVI in 419 tissue specimens of colorectal carcinoma. We performed univariate and multivariate analysis of the clinicopathologic features, frequency of recurrence, and outcome of patients with or without LVI and BVI.


The use of hematoxylin and eosin (H&E) staining to identify BVI and LVI yielded a false positive rate of 9.1% and false negative rate of 12.6%. The incidence of BVI was significantly higher among tumors with LVI than tumors without LVI (P <.001). In logistic multivariate analysis, only LVI (P < .001) was associated with lymph node metastasis and BVI (P = .015) was associated with distant recurrence. Calculating the prognostic relevance, both two invasion types correlated with decreased survival in univariate analysis (both P <.001). In multivariate analysis, BVI (P =.024), lymph node status (P =.003) and tumor stage (P <.001) remained statistically significant factors for survival.


Our results suggest that immunohistologic evaluation of BVI and LVI could be useful in colorectal carcinoma indicating the risk of lymph node metastasis and recurrence, thereby contributing to prognostic evaluation.


Colorectal carcinoma Blood vessel invasion Lymphatic vessel invasion Prognosis CD34 Podoplanin 



The authors thank Tsutomu Kohda for technical assistance and are grateful to Prof. J. Patrick Barron of the International Medical Communications Center of Tokyo Medical University for his review of this manuscript. This work was supported by the Tokyo Medical University Cancer Foundation (200409).


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Copyright information

© Society of Surgical Oncology 2006

Authors and Affiliations

  • Pin Liang
    • 1
    • 2
    • 4
  • Ichiro Nakada
    • 1
  • Jian-Wei Hong
    • 3
  • Takanobu Tabuchi
    • 1
  • Gyo Motohashi
    • 1
  • Akira Takemura
    • 1
  • Takeshi Nakachi
    • 1
  • Teruhiko Kasuga
    • 1
  • Takafumi Tabuchi
    • 1
  1. 1.Fourth Department of SurgeryTokyo Medical University Kasumigaura HospitalAmiJapan
  2. 2.Department of General SurgeryFirst Affiliated Hospital of Dalian Medical UniversityDalianChina
  3. 3.Department of PathologyTokyo Medical University Kasumigaura HospitalAmiJapan
  4. 4.Fourth Department of SurgeryTokyo Medical University Kasumigaura HospitalAmiJapan

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