Prognostic significance and effect of chemoradiotherapy on microvessel density (angiogenesis) in esophageal Barrett's esophagus-associated adenocarcinoma and squamous cell carcinoma

Previous studies have shown that intratumoral microvessel density (IMD) cor relates with clinical outcome in a variety of human neoplasms, such as thos e that arise in the breast, colon, and stomach, suggesting that angiogenesi s is important in cancer progression. The aims of this study were to evalua te the prognostic utility of IMD in esophageal Barrett's-associated adenoca rcinoma (AdCa) and squamous cell carcinoma (SCC), and to determine the effe ct of preoperative chemoradiotherapy (chemrad) on this process. Tissue sect ions of tumor from 67 patients with esophageal carcinoma (45 with Barrett's -associated AdCa, 22 with SCC) were stained with the vascular marker CD31. The IMD was calculated by evaluating at least 5 different 200 x fields of t umor hot spot areas to obtain the mean microvessel count (MVC). The data th en were correlated with the clinical and pathological features, chemrad sta tus, and patient survival. The MVC was significantly higher in AdCa (143 +/ - 63.2) compared wilh SCC (77.2 +/- 38.6, P = 0.0001). In AdCa, no correlat ion was noted between the MVC and any of the clinical or pathological featu res, including chemrad status. In contrast, in SCC, a statistically signifi cant higher MVC was detected in patients who did not receive chemrad (97.2 +/- 37.3) compared with those who did (48.3 +/- 15.9, P = .002) and in tumo rs that were larger in size (P = .02). However, the MVC did not correlate w ith survival in either AdCa or SCC (P > .05). The degree of angiogenesis is not a significant prognostic indicator in either esophageal AdCa or SCC. P reoperative chemrad has a positive effect on reducing the degree of angioge nesis in esophageal carcinoma, particularly SCC. Copyright (C) 1999 by W.B. Saunders Company