乳腺癌微血管密度与腋淋巴结转移及复发的关系

目的:观察乳腺癌组织中微血管密度(MVD)的分布,探讨其与临床病理特征及复发之间的关系,评价MVD对预后判断的价值.方法:采用免疫组化SABC法,检测74例乳腺癌组织内微血管牛成情况,并随访预后情况.结果:肿瘤越大,肿瘤分级越高,其MVD越高(P＜0.05).有腋淋巴结转移的MVD明显高于无淋巴结转移者(P＜0.05).复发患者的MVD明显高于无复发者(P＜0.01).VEGF C-erbB-2阳性组的MVD明显高于阴性组(P＜0.05).未发现MVD与P53、ER有相关性(P＞0.05).结论:肿瘤组织内微血管的生成程度与乳腺癌的复发转移密切相关,微血管密度可作为评估乳腺癌患者预后的指标之一.     

腋淋巴结阴性乳腺癌微血管密度与预后相关性研究

 目的: 探讨微血管生成与腋淋巴结阴性乳腺癌(ANNBC)临床病理及预后关系。方法: 免疫组化方法检测120例ANNBC石蜡标本中微血管密度(MVD), 分析MVD与临床病理因素及无复发生存率(RFS)、无转移生存率(MFS)和总体生存率(OS)的关系。结果: MVD 平均值38.21±18.72, 与多种临床病理因素无关; 复发转移ANNBC MVD值显著高于无病生存者; 高MVD 组(MVD>38)OS 、RFS 、MFS 曲线低于低MVD组(MVD ≤38), 差异有统计学意义(P<0.5 或P <0.01)。结论: 微血管生成活跃ANNBC预后不良, MVD可能是ANNBC一种较好的预后因子。     

乳腺癌组织中微血管密度检测的临床意义

目的　探讨乳腺癌组织内微血管密度与乳腺癌临床病理特征及预后的关系。方法　采用免疫组化SABC法 ,检测 49例乳腺癌组织内微血管生成情况。结果　腋淋巴结阳性组微血管密度为 (116.0± 43 .2 )个 /mm2 ,阴性组为 (74.5± 3 2 .8)个 /mm2 ,两者有显著性差异。瘤体直径≤ 2 .0cm组微血管密度为 (68.5± 2 4.9)个 /mm2 ,>2 .0cm组为 (10 8.2± 42 .7)个 /mm2 ,两者有显著性差异。c erbB2阳性表达组微血管密度为 (110 .1± 43 .9)个 /mm2 ,阴性组为 (81.0± 3 8.9)个 /mm2 ,两者有显著性差异。复发组微血管密度为 (119.0± 3 9.6)个 /mm2 ,未复发组为 (64 .4± 2 4.1)个 /mm2 ,两者有显著性差异。结论　肿瘤组织内微血管的生成程度与乳腺癌的生长和转移密切相关 ,微血管密度可作为评估乳腺癌患者预后的指标之一。     

微血管密度与腋窝淋巴结阴性乳腺癌预后的关系

目的:探讨微血管密度(microvesseldensity,MVD)与腋窝淋巴结阴性乳腺癌(axillary-node-negativebreastcancer,ANNBC)预后的关系.方法:应用免疫组化方法检测ANNBC标本的MVD,并将所测值与部分预后指标的关系进行统计学分析.结果:MVD与ANNBC患者年龄、内分泌状况、激素水平无关(P均>0.05),而与ANNBC患者的无瘤生存率(disease-freesurvival,DFS)和总生存率(overallsurvival,OS)有明显关系(P分别=0.0012和0.0039).结论:MVD是腋窝淋巴结阴性乳腺癌的独立预后因素,可以用于筛选高危患者进行综合辅助治疗.     

微血管密度与乳腺癌预后的关系

以免疫组织化学Ｓ－ＡＰ法，应用ＣＤ３４单克隆抗体特异性标记乳腺癌组织血管内皮细胞，检测乳腺癌组织内的微血管密度（ＭＶＤ），研究其与预后的关系。结果：ＭＶＤ最小值为３，最大值为５２，平均１５±８．５，除组织学分级与ＭＶＤ有统计学差异之外，肿瘤大小、绝经状态、淋巴结转移状况等均与ＭＶＤ无关。分析ＭＶＤ与预后的关系显示，ＭＶＤ≥１５的患者其术后５年生存率为４８．６％，而ＭＶＤ＜１５的患者的术后５年生存率为８１．０％，两组之间经Ｌｏｇｒａｎｋ检验差异有显著性。提示ＭＶＤ是乳腺癌的有价值的预后指标，而且可能成为一个较有意义、独立的乳腺癌预后因素     

腋淋巴结阴性乳腺癌中PTEN基因表达和微血管密度的关系及意义

目的:研究腋淋巴结阴性(lymph node negative,LNN)乳腺癌中PTEN蛋白的表达,探讨与微血管密度(MVD)及患者预后的关系.方法:应用免疫组化S-P法检测81例LNN乳腺癌及20例癌旁乳腺组织中PTEN和CD34蛋白的表达,分析与各临床病理因素和预后的关系.结果:32.6%的患者PTEN蛋白表达减低或完全阴性表达,PTEN与乳腺癌病理分级,ER状态和复发转移显著相关;PTEN阳性表达组的5年生存率(83.7%)明显高于阴性表达组(66.7%)(P＜0.05);PTEN的表达与MVD呈显著的负相关关系(r=-0.552,P＜0.01).结论:PTEN缺失是乳腺癌发生过程中的多发事件,并有抑制血管生成的作用,PTEN缺失和高MVD的LNN乳腺癌患者5年生存率低,两者的检测有助于提高评估LNN乳腺癌患者术后生存的准确性.     

血流能量图及微血管密度与乳腺癌腋窝淋巴结转移的相关性

目的：探讨血流能量图angio（Power Doppler Imaging,PDI）及微血管密度（microvessel density,MVD）与乳腺癌腋淋巴转移的相关性。方法：术前观察74例乳腺癌的血流信号及血流能量图特征;术后标本采用免疫组化检测癌巢内MVD值,比较PDI与MVD两种方法与乳腺癌腋淋巴结转移的关系。结果：43个有腋淋巴结转移（LN＋）组肿块以Ⅱ、Ⅲ级血流为主,血流主要分布在肿块周边多呈＂爪＂分布,血流信号较无腋淋巴结转移（LN-）组31个肿块明显丰富（P〈0.05）。LN＋组MVD值〉LN-组（P〈0.05）。癌巢内MVD值随Adler血流分级的增高和肿块体积的增大而测值增高（P〈0.05）,且随组织学级别的增加而显著增大（P〈0.05）。结论：乳腺癌的PDI及MVD值与腋淋巴结转移密切相关,二者结合可作为评估乳腺癌患者预后的重要指标。     

乳腺癌中微血管密度检测的临床意义

目的探讨组织内微血管密度与乳腺癌临床病理及预后间的关系.方法采用免疫组化SABC法检测49例乳腺癌组织内微血管的生成程度.结果腋淋巴结阳性转移组微血管密度为116.0±43.2个/mm2,阴性转移组为74.5±32.8个/mm2,两者间有显著性差异.瘤体"≤2.0cm"组微血管密度为68.5±24.9个/mm2,"＞2.0cm"组为108.2±42.7个/mm2,两者间有显著性差异.C-erbB-2阳性表达组微血管密度为110.1±43.9个/mm2,阴性组为81.0±38.9个/mm2,两者间有显著性差异.复发组微血管密度为119.0±39.6个/mm2,未复发组为64.4±24.1个/mm2,两者间有显著性差异.结论肿瘤组织内微血管的生成程度与乳腺癌的生长和转移关系密切,微血管密度可作为乳腺癌预后评估指标之一.     

血流能量图及微血管密度与乳腺癌腋窝淋巴结转移的相关性

目的:探讨血流能量图angio(Power Doppler Imaging,PDI)及微血管密度(microvessel density,MVD)与乳腺癌腋淋巴转移的相关性。方法:术前观察74例乳腺癌的血流信号及血流能量图特征;术后标本采用免疫组化检测癌巢内MVD值,比较PDI与MVD两种方法与乳腺癌腋淋巴结转移的关系。结果:43个有腋淋巴结转移(LN+)组肿块以Ⅱ、Ⅲ级血流为主,血流主要分布在肿块周边多呈"爪"分布,血流信号较无腋淋巴结转移(LN-)组31个肿块明显丰富(P<0.05)。LN+组MVD值>LN-组(P<0.05)。癌巢内MVD值随Adler血流分级的增高和肿块体积的增大而测值增高(P<0.05),且随组织学级别的增加而显著增大(P<0.05)。结论:乳腺癌的PDI及MVD值与腋淋巴结转移密切相关,二者结合可作为评估乳腺癌患者预后的重要指标。     

微血管密度对乳腺癌预后的意义

随着对肿瘤血管生长与抑制研究的逐渐深入，乳腺癌组织微血管密度与预后的关系越来越受到关注。研究表明，乳腺癌组织的微血管愈高，复发和转移的危险性愈大，预后 愈差；反之，微血管愈低，预后愈好。微血管密度比腋窝淋巴强的预后价值更大，可能成为一个最有意义的、独立的预后因素。同时，本文是出抑制微血管生成可作为防治乳腺癌复发和转移的有效措施，如果血管生长抑制剂配合其它疗法将可改善乳腺癌的预后。     

A meta-analysis of the relationship between lymphatic microvessel density and clinicopathological parameters in breast cancer

BackgroundBreast cancer is a common malignant neoplasm that is a leading cause of cancer death in women despite recent advances in treatment and research. The role of lymphangiogenesis in breast cancer development remains a source of controversy in current research.ObjectiveThe relationship between lymphatic microvessel density (LMVD) and the clinicopathological parameters of breast cancer can be effectively examined by meta-analysis of recent studies.MethodsA total of 10 relevant studies consisting of 1,044 total patients were examined by electronic searches of PubMed and Embase databases. Weighted mean difference (WMD) and 95% confidence intervals (CI) were estimated and pooled according to standard methods. LMVD data was pooled by tumor size, lymphatic node metastases, and tumor hormone receptor status of estrogen receptors (ER) and progesterone receptors (PR).ResultsA remarkable correlation between LMVD and lymph node metastases was observed in pooled analyses using a random-effects model (WMD: 2.72; 95%CI: 2.27, 3.16; P = 0.000). LMVD and tumor size showed a pooled WMD value of 0.00 (95%CI: -0.49, 0.50; P = 0.009), indicating no significant correlation between LMVD and tumor size. LMVD and either ER or PR status showed pooled WMD values of 0.24 (95%CI: -0.30, 0.79; P = 0.004) and -0.12 (95%CI: -0.81, 0.56, P = 0.301), respectively, also indicating no significant correlation between LMVD and ER or PR status.ConclusionA close relationship was observed between LMVD and lymph node metastases, though no correlation between LMVD and other important clinicopathological parameters was apparent. The current meta-analysis suggests that LMVD may be associated with increased metastatic activity in breast cancer, though the full role of lymphangiogenesis in breast cancer remains uncertain.     

二甲基苯蒽诱发大鼠乳腺癌的组织形态学和微血管密度观察

目的:研究诱发性大鼠乳腺癌发生过程中组织形态学变化和肿瘤微血管密度(MVD).方法:Wistar雌性大鼠85只,SD雌性大鼠22只,配制浓度为10 mg/ml的二甲基苯蒽(DMBA)麻油溶液灌胃大鼠.17只大鼠8周前死亡,剩余90只大鼠从第8周开始至24周,每2周取大鼠10只活杀,观察乳腺外形,取乳腺肿块HE染色和Ⅷ因子相关抗原免疫组化染色.结果:存活8周以上的90只大鼠中,73只成功诱发乳腺肿瘤,其中乳腺良性增生11只,乳腺癌62只.乳腺癌62只大鼠中,浸润性导管癌35只,浸润性小叶癌15只,乳头状腺癌5只,其他类型肿瘤7只.乳腺癌分化程度分级为:高分化5只,中分化36只,低分化21只.乳腺癌MVD平均值为(6.53±2.71)个/高倍视野,乳腺良性增生MVD为(1.67±0.95)个/高倍视野,乳腺癌MVD显著高于乳腺增生性疾病(P<0.01).低分化乳腺癌MVD显著高于中、高分化乳腺癌(P<0.001).结论:DMBA灌胃Wistar雌性大鼠乳腺癌诱发成功率高,肿瘤分化程度与微血管密度密切相关.     

二甲基苯蒽诱发大鼠乳腺癌的组织形态学和微血管密度观察

目的：研究诱发性大鼠乳腺癌发生过程中组织形态学变化和肿瘤微血管密度（MVD）。方法：Wistar雌性大鼠85只,SD雌性大鼠22只,配制浓度为10 mg/ml的二甲基苯蒽（DMBA）麻油溶液灌胃大鼠。17只大鼠8周前死亡,剩余90只大鼠从第8周开始至24周,每2周取大鼠10只活杀,观察乳腺外形,取乳腺肿块HE染色和Ⅷ因子相关抗原免疫组化染色。结果：存活8周以上的90只大鼠中,73只成功诱发乳腺肿瘤,其中乳腺良性增生11只,乳腺癌62只。乳腺癌62只大鼠中,浸润性导管癌35只,浸润性小叶癌15只,乳头状腺癌5只,其他类型肿瘤7只。乳腺癌分化程度分级为：高分化5只,中分化36只,低分化21只。乳腺癌MVD平均值为（6.53±2.71）个/高倍视野,乳腺良性增生MVD为（1.67±0.95）个/高倍视野,乳腺癌MVD显著高于乳腺增生性疾病（P〈0.01）。低分化乳腺癌MVD显著高于中、高分化乳腺癌（P〈0.001）。结论：DMBA灌胃Wistar雌性大鼠乳腺癌诱发成功率高,肿瘤分化程度与微血管密度密切相关。     

Influence of investigator experience and microscopic field size on microvessel density in node-negative breast carcinoma

In this study on the determination of intratumoralmicrovessel density (MVD) in breast cancer, we haveinvestigated the influence of the observer experience andthe microscopic field size. We have used thesample set reported on earlier in the JNatl Cancer Inst 87: 1797–1798, 1995. This case-controlstudy has shown a positive association of highMVD and unfavorable outcome when comparing node-negative pT1–2breast carcinoma (NNBC) patients with a disease-free periodof over ten years with those with anearly distant relapse.Tumor sections of both outcome groups (favorable: n= 19; unfavorable: n = 19) were immunostainedfor factor VIII related-antigen (FVIII r-Ag). Microvessels werecounted in the areas of most intense vascularization(hot spots), both at magnification × 200 (fieldsize of 0.61 square mm) and × 400(field size of 0.15 square mm), by oneinexperienced and three experienced observers. Microphotographs of individualvascular hot spots were analyzed using overlays resemblingthe two field sizes.The main results obtained are: i) a confirmationof the prognostic value of microvessel density inthe case-control sample set (n = 38) wasestablished by all experienced but not by theunexperienced investigator; ii) both at × 200 and× 400 magnification, angiogenesis quantification in vascular hotspots contained prognostic information.The results of this study indicate that theselection of vascular hot spots in tumor sectionsimmunostained for an antigen expressed on endothelial cellsis more prone to inter-observer variability and moredependent on training than the counting of themicrovessels within predefined hot spots itself. The microscopicmagnification and resulting field size do not influencethe prognostic significance of MVD in NNBC. Thisinformation validates the development of more objective methodsof measuring the amount of angiogenesis within malignanttissue. This will allow more accurate implementation ofthe angiogenesis parameter in multiparametric and prospective prognosticfactor studies in NNBC.     

The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic and macrophage infiltration, microvessel density and survival in patients with primary operable breast cancer

The significance of the inter-relationship between tumour and host local/systemic inflammatory responses in primary operable invasive breast cancer is limited. The inter-relationship between the systemic inflammatory response (pre-operative white cell count, C-reactive protein and albumin concentrations), standard clinicopathological factors, tumour T-lymphocytic (CD4+ and CD8+) and macrophage (CD68+) infiltration, proliferative (Ki-67) index and microvessel density (CD34+) was examined using immunohistochemistry and slide-counting techniques, and their prognostic values were examined in 168 patients with potentially curative resection of early-stage invasive breast cancer. Increased tumour grade and proliferative activity were associated with greater tumour T-lymphocyte (P<0.05) and macrophage (P<0.05) infiltration and microvessel density (P<0.01). The median follow-up of survivors was 72 months. During this period, 31 patients died; 18 died of their cancer. On univariate analysis, increased lymph-node involvement (P<0.01), negative hormonal receptor (P<0.10), lower albumin concentrations (P<0.01), increased tumour proliferation (P<0.05), increased tumour microvessel density (P<0.05), the extent of locoregional control (P<0.0001) and limited systemic treatment (P相似文献   

Prognostic significance of microvessel density and other variables in Japanese and British patients with primary invasive breast cancer

The purpose of this study is to investigate the associations of microvessel density (MVD) and other pathological variables with survival, and whether they accounted for survival differences between Japanese and British patients. One hundred seventy-three Japanese and 184 British patients were included in the study. British patients were significantly older (56.3+/-11.4 years vs 52.5+/-12.9 years; P<0.01) and had smaller tumours (2.2+/-1.3 vs 2.7+/-1.8 cm; P<0.01), which were more frequently oestrogen receptor positive (78.8 vs 57.2%, P<0.01), had more grade III tumours (29.9 vs 21.4%, P=0.04) and more infiltrating lobular carcinomas (13.6 vs 4.0%, P<0.01) and a higher MVD compared with Japanese patients (57.9+/-19.8 vs 53.2+/-18.6; P=0.01). However, no difference in the prevalence of lymph-node metastasis was found between them (39.1 vs 37.5%, P=0.75). Younger British patients (age <50 years) had the highest MVD compared with Japanese and older British patients (P<0.01). Japanese patients were proportionately more likely to receive chemotherapy than endocrine therapy (P<0.01). British patients had a significantly worse relapse-free survival and overall survival compared with Japanese patients, after statistical adjustment for variables (hazard ratio=2.1, 2.4, P<0.01, P<0.01, respectively), especially, in T2 stage, low MVD and older subgroup (HR: 3.6, 5.0; 3.1, 3.3; 3.2, 3.9, respectively), but only in ER negative cases (P=0.04, P=0.01, respectively). The present study shows that MVD contributes to the Japanese-British disparity in breast cancer. However, the MVD variability did not explain the survival differences between Japanese and British patients.     

乳腺密度、性激素和乳腺癌关系的研究进展

乳腺密度(mammographic breast density,BD)是乳腺癌危险性独立的预测指标,性激素也在乳腺癌的发展中扮演重要角色,而乳腺密度与性激素的关系仍不明确。本文将对乳腺密度,性激素,乳腺癌的关系进行综述。