VENOUS INVASION AS A PROGNOSTIC FACTOR IN INVASIVE PANCREATIC DUCTAL CANCER WITH SPECIAL REFERENCE TO DOUBLE STAINING OF HEMATOXYLIN-EOSIN AND VICTORIA-BLUE
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Background:Although double staining of Victoria-blue (VB) with Hematoxylin-eosin (HE) is recommended to accurately evaluate cancer invasion to small veins, there are no reports with this method in invasive pancreatic duct cell adenocarcinoma.Methods:The resected specimens from 40 patients with invasive pancreatic duct cell cancer were stained with double staining of HE-VB to evaluate the relation of venous invasion and clinico-pathological factors or prognosis in comparison to HE staining alone.Results:Eighteen (45%) of 40 cases were positive for venous invasion in HE staining alone, whereas the positive rate increased to 31 (77.5%) of 40 cases in HE-VB double staining. In HE staining, significant differences were recognized only with nerve invasion and UICC stage, but a significant relationship to venous invasion was also recognized for histological type and lymph node metastasis in double staining. Regarding the relationship between survival rate and venous invasion with double staining, the survival rate in the negative group was significantly higher than that in the positive group. In univariate analysis using Cox's proportional hazard model, lymph node metastasis and venous invasion under double staining were significant prognostic factors. However, any factors were not significant in multivariate analysis. Conclusion: These results suggest that venous invasion with double staining can be a prognostic factor in pancreatic cancer, and it has statistically significant correlation with several other clinico-pathological factors.
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