Abstract
Recent research suggests that multinodular recurrent pleomorphic adenoma (PA) might result from cell migration through lymphatics. Lymphangiogenesis in malignancies is mediated by vascular endothelial growth factors C and D (VEGF-C/D). We studied the expression of VEGF-C/D in PA by immunohistochemistry as well as lymphatic vessel density (LVD). In 6 non-recurrent, 4 primary-to-recur, and 10 recurrent PAs, VEGF-C/D expression was assessed by immunohistochemistry. Staining was scored in terms of staining intensity (0 = absent to 3 = strong), and the percentage of positive tumor cells (scored as 0 (0–19 %), 1 (20–39 %), 2 (40–50 %), and 3 (60–100 %)) and a sum score were calculated. Intra- and peritumoral LVD was assessed by counting of LV after immunostaining, using the D2-40 antibody. All but one sample were VEGF-C negative. The differences in VEGF-D expression between non-recurrent, primary-to-recur, and recurrent PAs were not significant (p > 0.05). VEGF-D expression did not correlate with peritumoral LVD (p > 0.05). Our study revealed a significant difference between intra- and peritumoral LVD values when comparing individual and all sample groups (p = 0.01). The lack of VEGF-C expression and of significant differences in VEGF-D expression and peritumoral LVD between patients with non-recurrent, primary-to-recur, and recurrent PAs does not support the lymphangiogenic local spread hypothesis.
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Acknowledgments
This study was supported by the Institutional Support of the Ministry of Health, Czech Republic, Nr. 1RVO-FNOL.2013, and IGA Czech Republic, Nr. NT13701-4/2012. Mr. George Kumsta is acknowledged for his help with the final English revision.
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The authors declare that they have no conflicts of interest.
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Salzman, R., Stárek, I., Kučerová, L. et al. Neither expression of VEGF-C/D nor lymph vessel density supports lymphatic invasion as the mechanism responsible for local spread of recurrent salivary pleomorphic adenoma. Virchows Arch 464, 29–34 (2014). https://doi.org/10.1007/s00428-013-1502-5
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DOI: https://doi.org/10.1007/s00428-013-1502-5