Clinical Significance of Lymphatic Microvessel Density and D2-40 Immunohistochemical Expression in Ovarian Cancer

Introduction: Lymphangiogenesis is the process of new lymphatic vessels formation from preexisting postcapillary venules. Although this process was extensively investigated in a large variety of human tumors, few data are available about the clinical significance of lymphatic vessels in ovarian cancer. The ovarian cancer is often characterized by an unpredictable behavior and there is a lack of data regarding the importance of lymphangiogenesis in the progression and spreading of this malignancy. Based on these data, we analyzed in the present paper the presence and density of lymphatic vessels in the peritumoral and intratumoral area. Material and methods: Slides from 35 patients with ovarian cancer were stained for the highly specific lymphatic endothelium marker D2-40. Lymphatic vessels were counted using Weidner’s method and results were correlated with conventional clinical and pathological parameters of prognosis. Results: We found lymphatic vessels in the peritumoral area in 32 cases and in the intratumoral area in 19 cases. Lymphatic microvessel density did not correlate with the histological type of carcinoma and with tumor’s grade, but a strong correlation was found with the stage of the tumor. D2-40 expression in tumor cells was found in six cases with high-grade advanced-stage serous adenocarcinoma. Conclusions: Our data suggest that lymphatic microvessel density and D2-40 expression by tumor cells could be important individual prognostic factors in patients with ovarian cancer, and in selected cases, D2-40 epitope of podoplanin could be a potential target for specific anticancer therapy.