Microvessel density of mantle cell lymphoma. A retrospective study of its prognostic role and the correlation with the Ki-67 and the mantle cell lymphoma international prognostic index in 177 cases
Abstrakt
The clinical course and therapy of mantle cell lymphoma (MCL) are heterogeneous and often unsatisfactory. Prognostic factors are needed to stratify the patients.
Microvessel density (MVD) has prognostic significance in some malignancies. There is little information about the vasculature of MCL, although some antiangiogenic drugs are in use.
We studied MVD using systematic uniform random sampling and unbiased counting frames in immunohistochemical reactions with anti-CD34 antibody in pretherapeutic extramedullary MCL samples of 177 patients. We analyzed the relationship of MVD to overall survival (OS) and progression-free survival (PFS), as well as to proliferative activity (Ki-67), mantle cell lymphoma prognostic index (MIPI), morphological variant, pattern of growth, and localization.
MVD varied widely: range 54.6-503.6 vessels/ mm2, median 158.2 vessels/mm2. Higher MVD was associated with bone marrow infiltration at the time of iagnosis (P= .001).
High MVD was associated with significantly worse S (P=0.04) only in patients treated with non-intensive conventional) therapy. MVD correlated positively with MIPI cores but not with the proliferation, morphological variant, rowth pattern, or localization.
Univariate analysis identified a rognostic influence of morphological variant, MIPI, and roliferative activity on OS and PFS and a prognostic influence f bone marrow infiltration at the time of diagnosis on FS. Multivariate analysis showed prognostic influence of MIPI and proliferative activity on OS and PFS only.
In conclusion, his is the first clinicopathological study of MVD of CL with long-term follow-up showing negative prognostic rends of highMVD inMCL and positive correlation ofMVD and MIPI.