Lymphatic vessel invasion in primary breast cancer using lymphatic endothelium marker, D240 and podoplanin

Lymphatic vessel invasion (LVI) has been conventionally assessed on hematoxylin-eosin (HE) stained section. But this assessment of lymphatic invasion has tended to be subjective depending on observer. The aim of this study is to investigate utility of lymphatic endothelium marker, D2-40 and Podoplanin. Materials used of this study were obtained from 69 patients with invasive breast cancer. Using D2-40 and Podoplanin, we investigated distribution of lymphatic vessel around the tumor and compared lymphatic vessel invasion. Correlation between LVI, lymph node metastasis, regional lymph node recurrence were also investigated. Lymphatic vessels were most frequently observed in "outside the tumor" (86%), whereas lymphatic vessels were not seen in "intratumor". LVI was found in 22 cases, of which 19 cases were "peritumor" (87%). Comparing HE and lymphatic markers, rates of low-grade LVI tended to be high. Concordance rate between D2-40 and Podoplanin were 94.2% (65/69). LVI assessed on HE section were corresponded to 57/69 cases (82.6%) either D240 or Podoplanin. Lymph node metastasis significantly correlated with LVI assessed by HE section, but not correlated with LVI assessed by lymphatic markers. Lymphatic endothelium markers, D2-40 and Podoplanin, are considered to be useful for detecting of LVI and can increase chance of detecting low-grade LVI.