Lymphovascular invasion explained
Lymphovascular invasion (LVI or lymphovascular space invasion) is the invasion of a cancer to the blood vessels and/or lymphatics.
Terminology
Lymph: A clear or white fluid that travels through vessels, moves within tissues and work to keep all the parts of the body clean.Vascular: The body's network of blood vessels.When cancer spreads to lymph and vascular system, it is thus termed as Lymphovascular Invasion.
Pathology
Lymphovascular invasion, especially in carcinomas, usually precedes spread to the lymph nodes that drain the tissue in which the tumour arose. Conversely, cancers with lymph node spread (known as a lymph node metastases), usually have lymphovascular invasion. Lymph node metastases usually precede secondary tumours, i.e. distant metastases.
The absence of LVI in the context of proven lymph node metastasis is usually thought to be due to sampling error.[1]
Prognostic significance
The predictive value and prevalence of lymphovascular invasion is strongly dependent on the type of cancer. In other words, LVI in one type of cancer may be much less important than LVI in another type of cancer.
Generally speaking, it is associated with lymph node metastases[2] [3] which themselves are predictive of a poorer prognosis.[4] In the context of (histologically) proven lymph node metastases, LVI may have less prognostic significance or no prognostic significance.
Breast cancer
Whether LVI is a significant prognostic factor in breast cancer is widely debated, and there is no clear consensus.[5] [6]
Urothelial carcinoma
See main article: Urothelial carcinoma. In urothelial carcinoma, LVI is an independent predictor of a poorer prognosis that has more predictive power than tumour stage.[7]
Colorectal cancer
See main article: Colorectal cancer. In sporadic colorectal carcinoma, LVI of a poorer prognosis.[8]
See also
Notes and References
- Han JS, Molberg KH, Sarode V . Predictors of invasion and axillary lymph node metastasis in patients with a core biopsy diagnosis of ductal carcinoma in situ: an analysis of 255 cases . The Breast Journal . 17 . 3 . 223–9 . 2011 . 21545433 . 10.1111/j.1524-4741.2011.01069.x . 9775260 . free .
- Schoppmann SF, Bayer G, Aumayr K, Taucher S, Geleff S, Rudas M, Kubista E, Hausmaninger H, Samonigg H, Gnant M, Jakesz R, Horvat R. 6 . Prognostic value of lymphangiogenesis and lymphovascular invasion in invasive breast cancer . Ann. Surg. . 240 . 2 . 306–12 . August 2004 . 15273556 . 1356408 . 10.1097/01.sla.0000133355.48672.22 .
- Fang WL, Chang SC, Lin JK, Wang HS, Yang SH, Jiang JK, Chen WC, Lin TC . Metastatic potential in T1 and T2 colorectal cancer . Hepatogastroenterology . 52 . 66 . 1688–91 . 2005 . 16334758 .
- Moreira LF, Kenmotsu M, Gochi A, Tanaka N, Orita K . Lymphovascular and neural invasion in low-lying rectal carcinoma . Cancer Detect. Prev. . 23 . 2 . 123–8 . 1999 . 10101593 . 10.1046/j.1525-1500.1999.09908.x .
- Ejlertsen B, Jensen MB, Rank F, Rasmussen BB, Christiansen P, Kroman N, Kvistgaard ME, Overgaard M, Toftdahl DB, Mouridsen HT . 6 . Population-based study of peritumoral lymphovascular invasion and outcome among patients with operable breast cancer . J. Natl. Cancer Inst. . 101 . 10 . 729–35 . May 2009 . 19436035 . 10.1093/jnci/djp090 . free .
- Song YJ, Shin SH, Cho JS, Park MH, Yoon JH, Jegal YJ . The role of lymphovascular invasion as a prognostic factor in patients with lymph node-positive operable invasive breast cancer . J Breast Cancer . 14 . 3 . 198–203 . September 2011 . 22031801 . 3200515 . 10.4048/jbc.2011.14.3.198 .
- Cheng . L. . Montironi . R. . Davidson . DD. . Lopez-Beltran . A. . Staging and reporting of urothelial carcinoma of the urinary bladder . Mod Pathol . 22 Suppl 2 . S70–95 . Jun 2009 . 10.1038/modpathol.2009.1 . 19494855 . free .
- Lim . SB. . Yu . CS. . Jang . SJ. . Kim . TW. . Kim . JH. . Kim . JC. . Prognostic significance of lymphovascular invasion in sporadic colorectal cancer . Dis Colon Rectum . 53 . 4 . 377–84 . Apr 2010 . 10.1007/DCR.0b013e3181cf8ae5 . 20305435 . 23220174 .
