ASSOCIATION OF TUMOR VASCULATURE WITH TUMOR PROGRESSION AND OVERALL SURVIVAL OF PATIENTS WITH NON-EARLY GASTRIC CARCINOMAS

In order to investigate the relationship between intratumoral vasculat ure and progression of gastric carcinomas and between vessel counts an d survival of patients with non-early gastric carcinoma, we counted th e intratumoral microvessels and compared their numbers with clinicopat hological parameters, as well as with the patients' survival. Microves sels were stained with anti-CD34 monoclonal antibody before counting b y microscopy (x200). In a group of 181 patients who had undergone tumo ur resection and were followed for more than 24 months the vessel coun ts for 83 patients with stage IV disease were significantly higher tha n those for patients with any other stage of disease. Among various cl inicopathological variables, haematogenous metastasis, lymph node meta stasis, peritoneal metastasis, stage IV disease and non-curative resec tion were more frequent in the patients with highly vascularized tumou rs (intratumoral vessel count > 155) than in those with less vasculari zed tumours. As a classification of stage IV disease such as haematoge nous or peritoneal metastasis generally indicates non-curative resecti on, it can be considered that the development of stage IV disease is a ssociated with the increase in tumour angiogenesis. Both univariate an d multivariate analyses showed that the intratumoral Vessel count was significantly predictive of overall survival, when tested as either a continuous or dichotomous variable. Cox hazards model analysis showed that the vessel count was one of the significant and independent progn ostic variables. Patients with highly vascularized tumours were signif icantly more likely to die than those with less vascularized tumours. Assessment of tumour vasculature may therefore be important, not only for its prognostic value, but also as it may help to predict responses to angiogenesis-inhibiting agents.