Detection of tumour lymphovascular space invasion using dual cytokeratin and CD31 immunohistochemistry

Background: Lymphovascular space invasion (LVSI) is an important step in the complex process of tumour metastasis. Various methods have been used in the past to improve the histological detection of LVSI. Aims: To develop a sensitive immunohistochemical method for the detection of LVSI. Methods: Paraffin wax blocks from 108 patients who had undergone hysterectomy for stage I endometrial cancer were retrieved. Dual immunostaining for pancytokeratin and the CD31 endothelial cell marker was carried out on 4 mum sections cut from these bocks and compared with conventional haematoxylin and eosin staining. Results: The detection rate for LVSI increased threefold compared with conventional haematoxylin and eosin staining in the test group. Conclusion: This finding suggests that LVSI is a much more common phenomenon than previously thought and questions current understanding of tumour metastasis.