Pattern of distribution and prognostic value of angiogenesis in pancreaticduct carcinoma: A semiquantitative immunohistochemical study of 45 patients

In specimens obtained from resected pancreata, the intratumoral microvessel density (IMD), the proliferation rate of the neoplastic parenchymal cells, and their p53 protein expression were assessed. The sources of errors were great in the measurements of the IMD. This statement can be illustrated by the finding that when the IMD was calculated by manual counting in five ar eas of intense neovascularization (hot spot regions), using x200 and x400 m agnifications, the numbers of microvessels per square millimeter were 65 +/ - 23 and 106 +/- 8, respectively, which reflects a significant difference. Two pat terns of microvessel distribution could be identified: one with hot spots only in the stroma(n = 19) and one in which the hot spots were locat ed in areas of neoplastic parenchyma (including its stroma) (n = 26). The I MD was significantly greater in the latter group. Then was no general corre lation of neoplastic disease with the IMD. However, when a scoring system w as used to assess the angiogenesis, hot spots in areas of neoplastic parenc hyma were associated with a greater proliferation rate of the tumor cells, and with a short length of survival of the patients from their neoplastic d isease.