EXTENT OF TUMOR VASCULARIZATION CORRELATES WITH PROGNOSIS AND HEMATOGENOUS METASTASIS IN GASTRIC CARCINOMAS

To determine whether tumor angiogenesis correlates with prognosis and metastasis of patients with gastric carcinoma, we counted the microves sels within the primary carcinoma and compared their numbers with the patient's prognosis and mode of metastasis, Tumor specimens from 110 p atients with gastric carcinoma, who had undergone curative resection m ore than 24 months before, mere investigated, Intratumoral microvessel s were stained with anti-CD34 and anti-von Willebrand factor monoclona l antibodies before being quantitated by light microscopy (x200), The antibody against von Willebrand factor often showed variability and st romal background staining, providing misleading low vessel counts, The data from three patients who died from nongastric carcinoma within 24 months after surgery were deleted, A total of 107 patients took part in the analysis examining the association between intratumoral microve ssels and clinical outcomes, Vessel counts derived from CD34 expressio n were significantly higher in patients who experienced hematogenous o r peritoneal metastasis after surgery than in patients with nonmetasta tic tumors, No correlation between vessel counts and lymph node metast asis was found, The prevalence of hematogenous metastasis, but not per itoneal metastasis, increased as the vessel counts increased, Multivar iate logistic regression and Cox hazards model analyses showed that th e vessel counts obtained with CD34 staining correlated with the develo pment of hematogenous recurrence but not peritoneal recurrence, It was the most important factor for predicting overall survival, These find ings support the hypothesis that tumor angiogenesis is closely related to the development of hematogenous metastasis in human gastric carcin omas, Assessment of tumor vascularization may, therefore, prove valuab le in identifying patients with gastric carcinoma at high risk for rec urrence who would benefit from adjuvant therapy.