Author of

• 20162

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  P1.13 - Radiology/Staging/Screening (ID 699)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Radiology/Staging/Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 22765

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    P1.13-009 - Macroscopic and Microscopic Lymphatic Remodeling Caused by VEGF-C Play a Key Role in Lymphatic Metastasis of Non-Small Cell Lung Cancer (ID 9726)

    09:30 - 16:00  |  Presenting Author(s): Hiromitsu Takizawa
    • Abstract

    Background:
    Computed tomography (CT) lymphography by transbronchial injection of a water-soluble extracellular CT contrast agent was developed as a new method for identifying sentinel nodes (SNs) in patient with non-small cell lung cancer (NSCLC). SNs were identified in 87.8% of patients, and the accuracy rate of SN identification was 97.5%. CT lymphography images sometimes show enlargement of lymphatic vessel (Fig), and we noticed this finding is related to lymph node metastasis. Lymphatic vessel enlargement was seen in 80% of lymph node metastasis positive cases whereas only 24.2% of lymph node metastasis negative cases showed lymphatic vessel enlargement (p=0.027). The aim of this study was to investigate the relationship between the finding of lymphatic vessel enlargement seen in CT lymphography and tumor lymphangiogenesis including lymphatic vessel density or vascular endothelial growth factor (VEGF)-C. Figure 1
    
    
    
    Method:
    Lymphatic vessel enlargement was defined as a finding of an enhanced lymphatic vessel ≥ 3mm on CT lymphography. We examined formalin fixed paraffin embedded tumor samples of 36 patients who received CT lymphography preoperatively. Lymphatic vessel density was determined based on the number of peritumoral vessels immunoreactive to anti-D2-40 antibody. The percentage of tumor cells exhibiting cytoplasmic staining for VEGF-C was evaluated and ≥ 30% was defined as VEGF-C positive.
    
    Result:
    Twelve out of 36 (33.3%) cases showed finding of the lymphatic vessel enlargement on CT lymphography. Peritumoral lymphatic vessel density of VEGF-C positive patients was significantly higher than that of VEGF-C negative patients (28.4 ± 11.6 vs 17.0 ± 10.5, p=0.005). Lymphatic vessel enlargement was more frequently seen in VEGF-C positive patients than in VEGF-C negative patients (53.8% vs 21.8% ± 10.5, p=0.056).
    
    Conclusion:
    Our study suggests VEGF-C secreted by tumor cells play a key role in the lymphatic remodeling and lymphatic vessel enlargement seen in CT lymphography may be a risk factor for lymph node metastasis of NSCLC.