Abstract:
Introduction. Prostate cancer (PC) is one of the most common malignant neoplasms in the male
population and exhibits marked biological heterogeneity, ranging from indolent forms to aggressive
variants characterised by an invasive tumour phenotype and increased metastatic potential. In this
context, the identification of histopathological markers with prognostic value is essential.
Lymphovascular invasion (LVI) is considered an important morphological parameter, as it has been
associated with an increased risk of tumour progression and disease recurrence.
Materials and Methods. The study included 70 patients diagnosed with acinar adenocarcinoma of the
prostate, who were investigated at the IMSP Institute of Oncology between 2022 and 2025. The mean
age of the patients was 67 ± 6.8 years (median: 68 years). Histopathological evaluation was performed
on haematoxylin–eosin (H&E)-stained sections. Statistical analysis included the calculation of the
mean and median, as well as Spearman’s correlation analysis, with the threshold for statistical
significance set at p < 0.05.
Results. The presence of lymphovascular invasion was histopathologically confirmed in 25 patients
(35.7%). Correlation analysis revealed statistically significant positive associations between LVI and
perineural invasion (rₛ = 0.21, p = 0.04). In addition, the incidence of LVI increased proportionally
with pathological pTNM staging (rₛ = 0.27, p = 0.01) and total Gleason score (rₛ = 0.54, p = 0.001).
Significant correlations were identified between LVI and the presence of lymph node metastases on
both the right side (rₛ = 0.42, p = 0.001) and the left side (rₛ = 0.52, p = 0.001). At the nodal level, LVI
showed a significant correlation with the presence of hyalinosis (rₛ = 0.49, p = 0.001). In contrast,
chronic prostatitis did not demonstrate a statistically significant association with LVI (rₛ = 0.13, p =
0.14). Furthermore, no significant correlations were observed between LVI and patient age, number of
involved lobes, prostatic capsular invasion, lymphocytic infiltrate, cellular atypia, lipid degeneration,
or sinus histiocytosis (p > 0.05).
Conclusions. Lymphovascular invasion, observed in more than one-third of the patients included in
this study, constitutes a histopathological marker linked to an aggressive tumour phenotype in prostate
cancer. Statistically significant associations with perineural infiltration, advanced pathological stage,
elevated Gleason scores and bilateral lymph node involvement reinforce its prognostic relevance.
Moreover, the relationship with nodal stromal changes, including hyalinosis, indicates a possible role
of lymphovascular invasion in the processes governing metastatic spread. Accordingly, this parameter
may serve as a meaningful indicator of metastatic propensity and tumour biological severity, with
practical implications for risk stratification and clinical decision-making in prostate cancer
management.
