Immunohistochemical Method Identifies Lymphovascular Invasion in a Majority of Oral Squamous Cell Carcinomas and Discriminates Between Blood and Lymphatic Vessel Invasion
Rebekah K. O’Donnell 1*, Michael Feldman 1, Rosemarie Mick 1 and Ruth J. Muschel 1
1 Department of Pathology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania (RKO,RJM); Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (MF); and Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (RM)
* To whom correspondence should be addressed. E-mail: rebekah.k.odonnell{at}gmail.com.
Submitted on January 20, 2008
Accepted on 5 May 2008
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Abstract |
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Tumor invasion into blood and/or lymphatic channels is an important component of cancer staging and prognosis. Standard pathological methods do not provide sufficient contrast to discriminate between invasion into each type of vessel and are complicated by tissue retraction artifacts. We evaluated the ability of a triple-stain immunohistochemical method, combining cytokeratin, CD34, and podoplanin stains in a single section, to distinguish blood from lymphatic vascular invasion in oral squamous cell carcinoma and confirmed its results using multispectral analysis. The triple-stain method was significantly more sensitive in detecting invasive events than the standard H&E staining method and easily discriminated between blood and lymphatic vessel invasion. Invasive events were present in blood and/or lymphatic vessels in the majority of patients with and without presentation of lymph node metastasis, indicating that vessel invasion in this cancer model is common and is not a rate-limiting step for lymph node metastasis.
Key Words:
vessel invasion, metastasis, oral squamous cell carcinoma, immunohistochemistry