MORPHOLOGICAL CHARACTERISTICS AND CLINICAL VALUE OF DIFFERENT TYPES OF VESSELS INTO A TISSUE OF REGIONAL LYMPH NODES IN PATIENTS WITH GASTRIC CANCER

Introduction: Features of angiogenesis in regional lymph node (RLN) in patients with gastric cancer are not well understood. The aim of our study is to give morphological characteristics and clinical evaluation of different types of vessels in the tissue of RLN in patients with gastric cancer.

Materials and methods: Specimens of RLN without metastases in 32 patients with gastric cancer were investigated. Sections were stained with hematoxylin and eosin and immunohistochemistry (IHC) with CD34 antibodies was performed.

Results: It was found that the density of cells expressing CD34 in lymphocytes of LN is correlated with the ПМС in the cortical layer of LN (r = 0.483, p = 0.005), with cell density in LN (r = 0.550, p = 0.01) and with the number of lymphocytes in gastric mucosa (r = 0.576, p = 0.001). The density of cells expressing CD34 in lymphocytes in LN was higher in gastric mucosa with multiple lymphocytes (7.21 + 2.91 and 13,47 + 6.45 respectively in gastric mucosa with single and multiple lymphocytes, p = 0.006). Tin tissues of RLN identified 3 types of vessels having different morphology and clinical significance: capillaries with usual structure, dilated capillaries and atypical vessels.  ПМС in cortex layer of LN correlated with the stage of gastric cancer (r = -0,410, p = 0.01) and the number of metastases in RLN (r = -0,440, p = 0.01).

ПМС was lower in cases of locally advanced gastric cancer (28.4 + 4.91, 32.5 + 13.32  and 23.79 + 6.193 in microvessels on УЕП, at the stage of T1-2N0M0, T3N0M0 and T2-4N1-2M0, respectively, p1 -3 = 0.02) and in multiple metastases in the RLN (29.8 + 8.51, 25.2 + 5.82  and 22.7 + 6.63 respectively in microvessels on УЕП in the absence of single and multiple metastases, p1 - 3 = 0.001). The presence of multiple atypical vessels was also correlated with the stage of gastric cancer (r = 0,390, p = 0.04) and with 3-year disease-free survival (r = 0,630, p = 0.002). For early stages of gastric cancer it was characterized the absence of abnormal blood vessels in paracortical layer. Whereas in locally advanced gastric cancer atypical vessels were often detected. When there are multiple atypical vessels into a tissue of LN, a decrease of 3-year relapse-free survival from 87% to 42.9% was established (p = 0.03). While when the sinuses in the LN were preserved it was associated with its increase (83.8% and 57.1% for the presence and the absence of sinuses in RLN respectively, p = 0.04).

Conclusion: these data suggest a close relationship between lymphoproliferative processes in the lymph nodes and in the gastric mucosa with each other and with the processes of angiogenesis. The origin of the abnormal vessels requires further research.

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