SOFT TISSUE SARCOMA: PATHOLOGICAL DEMONSTRATION OF VASCULARIZATION

The investigation and determination of the significance of neovascularization in the progression of soft tissue sarcoma is currently of increasing clinical importance. Microvessel density is the morphologic evidence of neoangiogenesis in the process of malignant progression of sarcomata. This brief review of the markers commonly used in clinical practice was undertaken to determine the validity of the application of these markers in the quantitation of neoangiogenesis in sarcomata. The material selection was based only on primary material from untreated cases that were part of the inhospital and consultation practices. From this investigation, one can conclude that not all markers have equal value in either the qualitative or quantitative assessment of vascularization in tumors. Laminin was found to have low sensitivity. Factor VIII was found to have extreme sensitivity but lack specificity. A combination of collagen IV, smooth muscle actin, CD34 and CD31 markers were found to represent the most reliable identificators of blood vessels in sarcomata. Morphological identification of vessels may be further supplemented by proliferation markers (e.g. PCNA, Ki67) as indicators for,not only the presence of blood vessels, but also to determine the activity of endothelial cells in blood vessel growth.