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Objective To explore the value of apparent diffusion coefficient(ADC)on reduced field-of-view diffusion-weighted magnetic resonance imaging(r-FOV DWI)in assessing lymphovascular invasion(LVI)of extrahepatic cholangiocarcinoma(EHCC).Methods Fifty-four patients with pathologically confirmed EHCC underwent pre-operative conventional and r-FOV DWI.Two senior radiologists evaluated the image quality using a 5-point Likert scale and measured the signal-to-noise ratios(SNR), contrast-to-noise ratios(CNR), and ADC values of the lesions on DWI.According to pathological data, patients were divided into the LVI-positive group and the LVI-negative groups.The conventional and r-FOV ADC values for demonstrating LVI were compared between the two groups using the receiver operating characteristic(ROC)curves.Results The image quality of r-FOV DWI was better with higher scores than that of conventional DWI with significantly higher subjective scores as well as lower SNR, CNR, and ADC values than that of conventional DWI(P＜0.05).Both conventional and r-FOV ADC values in the LVI-positive group were significantly lower than those in the LVI-negative group(P＜0.05).The area under the ROC curve(AUC)for diagnosing LVI using conventional ADC value＜1.217×10-3 mm²/s was 0.746(P＜0.05), with 75.0％sensitivity and 73.5％specificity.The AUC for diagnosing LVI using r-FOV ADC value＜1.092×10-3 mm²/s was 0.932(P＜0.05)with 95.0％sensitivity and 85.3％specificity.The difference in AUC values between the two groups was statistically significant(P＜0.05).Conclusion r-FOV ADC values are better than conventional ADC values for demonstrating LVI of EHCC. [ABSTRACT FROM AUTHOR]

Breast cancer has become the most common malignant tumor in women, and its diagnosis and treatment principles mainly depend on the traditional histological and molecular pathological features. However, the systemic metastasis of breast cancer begins when cancer cells invade the primary tumor site as well as surrounding blood and lymphatic vessels. Pathologists have been able to distinguish between lymphatic and vascular invasion through a combination of immunohistochemical and vascular endothelial labelling techniques, and have recognized the role of lymphatic endothelial cells and vascular endothelial cells in tumor progression and metastasis. This paper summarizes the relevant clinical research progress and application of specific lymphovascular endothelial markers in breast cancer in recent years, in order to provide ideas for further revealing the progress mechanism of breast cancer and exploring new prognostic indicators and therapeutic targets for breast cancer.

Objective To explore the preoperative predictors of lymphovascular invasion (LVI) in patients with advanced gastric cancer, and establish the corresponding nomogram prediction model and conduct internal validation. Methods A total of 246 cases of advanced gastric cancer who underwent surgical resection in the Department of Gastrointestinal Surgery of Hengshui People's Hospital from January 2018 to December 2021 were selected. Patients were divided into the LVI positive group and the LVI negative group according to postoperative pathological diagnosis. The age, gender, tumor differentiation, tumor size, tumor site, Borrmann classification, Lauren's classification, cT stage, cN stage and systemic immune-inflammation index (SII) of patients were collected and compared between the two groups. The predictors that were statistically different between the two groups were subjected to multivariate Logistic regression and further developed into a visual prediction model. Bootstrap method was applied for internal validation of the prediction efficiency of the model. Results The differences of tumor size, Borrmann classification, tumor differentiation, Lauren classification, cT staging, cN staging and SII were statistically significant between the two groups ( P＜0.05). Multivariate Logistic regression analysis showed that tumor size (OR=2.184, 95%CI: 1.224-3.898), Borrmann classification (OR=2.517, 95%CI: 1.294- 4.896), cT staging (OR=1.860, 95%CI: 1.045-3.308), cN staging (OR=1.816, 95%CI: 1.004-3.285) and SII (OR=1.001, 95%CI: 1.000-1.002) were independent predictors of LVI in advanced gastric cancer. A preoperative nomogram prediction model for advanced gastric cancer LVI was developed based on results of multivariate analysis. By internal validation, the area under curve (AUC) value of the subject operating characteristic (ROC) curve of the nomogram was 0.735, which was higher than that of tumor size (0.599), Borrmann staging (0.564), cT staging (0.604), cN staging (0.582) and SII (0.615), respectively. The calibration curve showed that the probability of predicted LVI by the nomogram was in a good agreement with the probability of actual LVI occurrence. The Hosmer-Lemeshow test showed good model fit (χ² =4.387, P=0.821). Conclusion The established nomogram prediction model can help to predict the probability of LVI in advanced gastric cancer preoperatively, which can provide a guideline for clinical individualized treatment. [ABSTRACT FROM AUTHOR]

Objective To investigate the predictive value of preoperative hematological inflammatory markers in gastric cancer (GC) with lymphovascular invasion(LVI). Methods A retrospective study was conducted on 341 GC patients who undergoing surgical resection and confirmed by pathological examination in Jiangsu Cancer Hospital from October 2020 to July 2022. The patients were divided into a positive group (n=163) and a negative group (n=178) based on the presence or absence of vascular cancer thrombi in postoperative pathology. Before operation, the following clinical data were collected, including neutrophil to lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio(LMR), fibrinogen-lymphocyte ratio (FLR) and common tumor markers. The receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of NLR, PLR and FLR for LVI to find the optimal cut-off values. Univariate logistic regression was used to analyze the influencing factors of LVI in GC patients, and a logistic regression model for predicting LVI in GC patients was constructed. Results Compared with those in the patients with LVI negative, the levels of NLR, PLR, FLR and carbohydrate antigen (CA)19-9, the tumor infiltration depth and the rate of lymph node metastasis rate significantly increased in LVI positive patients(P＜0.05). ROC curve analysis showed that the best cutoff values of NLR, PLR and FLR were 1.68, 115.29 and 1.96 respectively. The logistic regression model of LVI in GC patients showed that Logit(P)=-2.117+0.890×X1+0.286×X2+0.917×X3(X1=PLR, X2=cT, X3=lymph node metastasis) had a good model fit(χ=58.405, P＜0.01), with the prediction accuracy of 67.26% and an AUC of 0.733 (95%CI: 0.680-0.786, P＜0.01), and this model analysis suggested that PLR(＞115.29, OR=2.436, 95%CI: 1.386-4.282, P=0.002), cT stage (OR=1.331, 95%CI: 1.031-1.749, P=0.030) and lymph node metastasis(OR=2.503, 95%CI: 1.507-4.156, P＜0.001) were the independent risk factors for LVI in patients with GC. Conclusion Preoperative monitoring of PLR level has a certain predictive value in evaluating the occurrence of LVI in GC patients, and can be used as a supplementary indicator to judge the formation of LVI.

Objective·To explore the prognosis effects of tumor-stroma ratio(TSR), perineural invasion (PNI) and lymphovascular invasion (LVI) on patients with colorectal cancer (CRC). Methods·Data of 948 patients diagnosed with CRC in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January 2014 to December 2018 were retrospectively analyzed, and according to pathological risk factors TSR, PNI and LVI, patients were divided into high risk group (n=81) and low risk group (n=867). After 1-1 matching with SPSS software, 67 patients of the high risk group and 67 patients of the low risk group were obtained. The overall survival (OS) time was compared between patients in the high risk group and low risk group. The results were validated by using tissue microarray (TMA) dataset of 106 CRC patients from our research group. The clinical characteristics of the high risk group and low risk group were compared. Kaplan-Meier curve was used for survival analysis, and COX regression model was used to analyze the prognosis factors. Results·Patients in the high risk group had a worse prognosis with a short median OS (27.7 months) than patients in the low risk group (31.1 months, P=0.000). The worse OS in patients with high risk group was validated in matched data and TMA dataset. Conclusion·CRC with positive perineural lymphovascular invasion combined with high TSR is a type of CRC with poor prognosis, which can effectively make up for the defect of tumor-node-metastasis (TNM) stage in prognosis and can be used to predict postoperative disease development of CRC patients and guide treatment. [ABSTRACT FROM AUTHOR]

Objective To explore the feasibility of predicting lymphovascular invasion(LVI) in invasive breast cancer using preoperative nomogram based on contrast-enhanced magnetic resonance imaging(MRI). Methods Between January 2016 and December 2018, 256 patients with invasive breast cancer confirmed by surgical pathology underwent conventional MRI, diffusion-weighted imaging(DWI) and dynamic contrast-enhanced MRI. LVI was identified by postoperative pathology. The 256 patients were randomly divided into the training(n=171) and validation(85) groups. LASSO regression was used to select predictors that are most associated with LVI of breast cancer. A nomogram was constructed. The receiver operating characteristic(ROC) curve analysis was used to determine the diagnostic performance and the area under ROC curve( AUC), sensitivity, specificity, accuracy, positive prediction value(PPV) and negative prediction value(NPV) were calculated. Results Of 256 patients, 99(38.7%) had LVI. Eight parameters derived from MRI and HER-2 were associated with LVI. The AUC for nomogram(0.843, 0.833), sensitivity(76.3%,65.0%), specificity(77.7%, 84.4%), accuracy(77.2%, 75.3%), PPV(64.3%, 78.8%), and NPV(86.1%, 73.1%) were determined in the training and validations groups, respectively. Conclusion We developed and validated a nomogram to predict LVI as a reference for clinical decision-making in patients with invasive breast cancer. [ABSTRACT FROM AUTHOR]

Objective To investigate the related factors of stage Ⅰ pulmonary adenocarcinoma with lymphovascular invasion. Methods Clinical data of 229 patients with stage Ⅰ lung adenocarcinoma treated by surgical treatment and pathologically diagnosed as stage Ⅰ lung adenocarcinoma in Tianjin Chest Hospital from January 2016 to May 2018 were retrospectively analyzed. The patients were divided into two groups: lymphovascular invasion group and non-lymphovascular invasion group, and the influencing factors of lymphovascular invasion for lung adenocarcinoma in stage Ⅰ were analyzed. Results The univariate factor analysis showed that pulmonary adenocarcinoma in stage Ⅰ with lymphovascular invasion was related to diameter of tumor, lepidic pattern, acinar pattern, papillary pattern, micropapillary pattern, pleural invasion, preoperative neutrophil-lymphocyte ratio (NLR) and preoperative carcinoembryonic antigen (CEA, P＜0.05). Multivariate Logistic regression analysis showed that diameter of tumor ≥ 2.2 cm, micropapillary pattern ≥ 12.8% and pleural invasion were the risk factors for lymphovascular invasion. Conclusion Attention should be paid to the risk factors of lymphovascular invasion in clinic, such as tumor diameter, micropapillary pattern and visceral pleural invasion. And the patients with lymphovascular invasion should be treated as early as possible so as to prolong their survival time. [ABSTRACT FROM AUTHOR]