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Microvessel Density: Correlation with ¹⁸F-FDG Uptake and Prognostic Impact in Lung Adenocarcinomas

¹ Department of Radiology, Kanazawa Medical University, Ishikawa, Japan; ² Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, People's Republic of China; ³ Department of Pathology, Kanazawa Medical University, Ishikawa, Japan; ⁴ Department of Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan; ⁵ Division of Respiratory Disease, Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan; and ⁶ Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan

View larger version (137K): [in a new window]   FIGURE 1.  (A) Adenocarcinoma with diffuse pattern stained by mAb to CD31. Normal structure was destroyed, and vessels were randomly and diffusely distributed throughout tumor. (B) Adenocarcinoma with alveolar pattern stained by mAb to CD31. Vessels (arrows) in alveolar pattern area were in original distribution; tumor cells filled up alveoli instead of destroying them. (C) Normal alveoli. (D) Consecutive section of same tumor as in B stained by mAb to CD105. Trapped vessels showed negative staining (arrows).

View larger version (65K): [in a new window]   FIGURE 2.  Comparison between CD34/-SMA double labeling and CD105 in serial sections. (A) Double labeling of CD34 (arrow) and -SMA (arrowheads). Left vessel was immature vessel showing staining only with CD34. Right vessel was mature vessel showing staining with both CD34 and -SMA. (B) CD105 staining. Only left, immature vessel was positive for CD105 (arrow). Right, mature vessel was negative for CD105 (double arrows).

View larger version (10K): [in a new window]   FIGURE 3.  (A) CD31-MVD showed negative correlation with 18F-FDG uptake (P = 0.057). (B) CD105-MVD showed significantly positive correlation with 18F-FDG uptake (P < 0.0001).

View larger version (35K): [in a new window]   FIGURE 4.  Kaplan–Meier survival curves based on MVDs in lung adenocarcinomas. Patients with low CD31-MVD had worst disease-free and overall survival probabilities (A and C), whereas patients with low CD105-MVD had best disease-free and overall survival probabilities (B and D).

View larger version (127K): [in a new window]   FIGURE 5.  Moderately differentiated adenocarcinoma (2.9 cm) with recurrence in 23 mo. (A) CT scan shows nodule in left lung. (B) 18F-FDG PET shows intense uptake of 18F-FDG in tumor (SUV = 5.76). (C) CD31 immunohistochemical analysis shows high MVD. (D) CD105 immunohistochemical analysis also shows high MVD.

View larger version (139K): [in a new window]   FIGURE 6.  BAC (2.0 cm) without recurrence in 50 mo. (A) CT scan shows nodule in right lung. (B) 18F-FDG PET shows modest uptake of 18F-FDG in tumor (SUV = 1.32). (C) CD31 immunohistochemical analysis shows moderate MVD. (D) CD105 immunohistochemical analysis shows low MVD.