g several factors which have been evaluated for prognostic significance in patents with some types of solid tumors, tumor angiogenesis is reportedly correlated wit metastasis, relapse, and prognosis, that tumor growth is angiogenesis-dependent
has
been
suggested by many studies that after a new tumor has attained a small size of a few millimeters in diameter(about 10E6 cells), further expansion of the tumor-cell population requires the induction of new capillary blood vessels. Besides an
increase
in
the delivery of nutrients to the tumor cells, this neovascularization also increases the opportunity for tumor cells to enter the circulation, which should imply the importance of tumor angiogenesis for the metastatic potentia of tumors.
This study was designed to examine the microvessel count at the invasive margin in advanced gastric carcinoma to investigate the correlation between tumor angiogenetic activity and progression of gastric carcinoma using a immunohistochemical
technique.
103 specimens resected from patients with advanced gastric carcinoma were investigated by immunostaining with a monoclonal antibody against factor VIII-related antigen. Correlation between the angiogenesis score (the mean number of microvessels
in
at
least five areas of highest vascular density at 200 times magnification), various clinicopathologic factors, and prognosis were studied.
The sex ratio (p=0.8589), invasiveness of bowel wall(p=0.16791), histologic grades(p=0.8579), lymphatic invasion in tumor(p=0.9515), venous invasion in tumor(p=0.8976), and tumor size(p=0.3200) are not correlated with angiogenesis factor. But the
invasion of lymph nodes (p=0.0015) and recurrence rate(p=0.004) are significantly correlated with angiogenesis factor.
This retrospective study demonstrates that angiogenesis expressed as angiogenesis score may be a good prognostic indicator and may be useful as a predictor for recurrence in patients with advanced gastric carcinoma. If these findings are
confirmed
in
larger prospective studies, it might be possible to add microvessel count to other prognostic factors to identify patients at higher risk for recurrence and to guide decisions on more aggressive adjavant therapy after surgery.
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