Clinical Significance of Detecting Lymphatic and Blood Vessel Invasion in Stage II Colon Cancer Using Markers D2-40 and CD34 in Combination


This research was conducted to compare differences in colon cancer lymphatic vessel invasion (LVI) withD2-40 antibody labeling and regular HE staining, blood vessel invasion (BVI) with CD34 antibody labeling andHE staining and to assess the possibility of using D2-40-LVI/CD34-BVI in combination for predicting stage IIcolon cancer prognosis and guiding adjuvant chemotherapy.Anti-D2-40 and anti-CD34 antibodies were applied totissue samples of 220 cases of stage II colon cancer to label lymphatic vessels and small blood vessels, respectively.LVI and BVI were assessed and multivariate COX regression analysis was performed for associations with coloncancer prognosis. Regular HE staining proved unable to differentiate lymphatic vessels from blood vessels,while D2-40 selectively labeled lymphatic endothelial cell cytosol and CD34 was widely expressed in large andsmall blood vessels of tumors as well as normal tissues. Compared to regular HE staining, D2-40-labeling forLVI and CD34-labeling for BVI significantly increased positive rate (22.3% vs 10.0% for LVI, and 19.1% vs9.1% for BVI). Multivariate analysis indicated that TNM stage, pathology tissue type, post-surgery adjuvantchemotherapy, D2-40-LVI, and CD34-BVI were independent factors affecting whole group colon cancer prognosis,while HE staining-BVI, HE staining-LVI were not significantly related. When CD34-BVI/D2-40-LVI were usedin combination for detection, the risk of death for patients with two or one positive results was 5.003 timesthat in the LVI(-)&BVI(-) group (95% CI 2.365 - 9.679). D2-40 antibody LVI labeling and CD34 antibody BVIlabeling have higher specificity and accuracy than regular HE staining and can be used as molecular biologicalindicators for prognosis prediction and guidance of adjuvant chemotherapy for stage II colon cancer.