Lymphangiogenesis and cancer metastasis

Anatomy and function of the lymphatic system Tumour-induced lymphangiogenesis promotes metastasis Tumour-induced lymph node lymphangiogenesis precedes cancer metastasis to lymph nodes Tumour cell invasion into lymphatic vessels Peri- and intra-tumoral lymphangiogenesis Lymphatic vessel markers and lymphangiogenic growth factors Preventive and therapeutic potential of anti-lymphangiogenic treatment Tumour lymphangiogenesis as a prognostic indicator for lymph node metastasis Lymphatic vessel density Lymphatic invasion by tumour cells Lymphangiogenic growth factors Lymph node lymphangiogenesis Diagnostic value of tumour-associated lymphangiogenesis Imaging of lymphatic vessels Imaging lymphatic drainage Non-invasive imaging of lymph node metastases Metastasis is a characteristic trait of most tumour types and the cause for the majority of cancer deaths. Many tumour types, including melanoma and breast and prostate cancers, first metastasize via lymphatic vessels to their regional lymph nodes. Although the connection between lymph node metastases and shorter survival times of patients was made decades ago, the active involvement of the lymphatic system in cancer, metastasis has been unravelled only recently, after molecular markers of lymphatic vessels were identified. A growing body of evidence indicates that tumour-induced lymphangiogenesis is a predictive indicator of metastasis to lymph nodes and might also be a target for prevention of metastasis. This article reviews the current understanding of lymphangiogenesis in cancer anti-lymphangiogenic strategies for prevention and therapy of metastatic disease, quantification of lymphangiogenesis for the prognosis and diagnosis of metastasis and in vivo imaging technologies for the assessment of lymphatic vessels, drainage and lymph nodes.