Clinicopathologic Features Predicting Involvement of Nonsentinel Axillary Lymph Nodes in Iranian Women with Breast Cancer

Background: Almost half of the breast cancer patients with positive sentinel lymph nodes have no additional disease in the remaining axillary lymph nodes. This group of patients do not benefit from complete axillary lymph node dissection. This study was designed to assess the clinicopathologic factors that predict non-sentinel lymph node metastasis in Iranian breast cancer patients with positive sentinel lymph nodes. Materials and Methods: The records of patients who underwent sentinel lymph node biopsy, between 2003 and 2012, were reviewed. Patients with at least one positive sentinel lymph node who underwent completion axillary lymph node dissection were enrolled in the present study. Demographic and clinicopathologic characteristics including age, primary tumor size, histological and nuclear grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and number of harvested lymph nodes, were evaluated. Results: The data of 167 patients were analyzed. A total of 92 (55.1%) had non-sentinel lymph node metastasis. Univariate analysis of data revealed that age, primary tumor size, histological grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio, wereassociated with non-sentinel lymph node metastasis. After logistic regression analysis, age (OR=0.13; 95% CI, 0.02-0.8), primary tumor size (OR=7.7; 95% CI, 1.4-42.2), lymphovascular invasion (OR=19.4; 95% CI, 1.4-268.6), extracapsular invasion (OR=13.3; 95% CI, 2.3-76), and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio (OR=20.2; 95% CI, 3.4-121.9), were significantly associated with non-sentinel lymph node metastasis. Conclusions: According to this study, age, primary tumor size, lymphovascular invasion, extracapsular invasion, and the ratio of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes, were found to be independent predictors of non-sentinel lymph node metastasis.     

胃癌淋巴管密度、微血管密度水平及其临床意义

目的 探讨胃癌组织中淋巴管密度（LVD）和微血管密度（MVD）水平及两者与胃癌临床病理特征的关系。方法 收集本院2004年2月至2007年2月手术切除的68例胃癌患者肿瘤组织,分别采用D2-40和CD31标记胃癌组织中淋巴管和血管,采用免疫组化法检测瘤周及瘤内D2 40、CD31表达情况并计算LVD和MVD,分析瘤周及瘤内LVD、MVD水平与临床病理参数（肿瘤大小、淋巴结转移、脏器转移、TNM分期、性别、年龄、分化程度、Lauren分型及病理类型）和预后的关系。结果 68例患者瘤内和瘤周LVD分别为（4.6±2.0）个和（8.2±3.5）个,瘤内和瘤周MVD分别为（46.3±16.5）个和（47.6±15.3）个;瘤周LVD与肿瘤大小、淋巴结转移、脏器转移及TNM分期有关（P＜0.05）,与性别、年龄、分化程度、Lauren分型及病理类型均无关（P＞0.05）;瘤内LVD、瘤内及瘤周MVD与以上参数均无关（P＞0.05）;全组中位总生存期（OS）为48.6个月,其中瘤周低LVD者的中位OS为31.0个月,低于瘤周高LVD的43.0个月（P＜0.05）;瘤周高MVD者的中位OS为46.0个月,而瘤周低MVD者为48.0个月,差异无统计学意义（P＞0.05）。结论 瘤周LVD与胃癌的临床病理特征及预后密切相关,可能成为胃癌发展及预后的预测指标。     

The Pre-Treatment Neutrophil-Lymphocyte Ratio: a Useful Tool in Predicting Non-Sentinel Lymph Node Metastasis in Breast Cancer Cases

Background: The sentinel lymph node (SLN) biopsy is a highly accurate predictor of overall axillary nodal status in early breast cancer patients. There is however, still a debate on which patients with a positive SLN can benefit from axillary lymph node dissection (ALND). Numerous studies have been designed to identify variables that are predictive of non-SLN metastasis to avoid a complete ALND. The aim of this study was to determine whether the pre-treatment neutrophil-lymphocyte ratio (NLR) can be a predictive factor of non-SLN metastasis in early breast cancer patients. Materials and Methods: The records of 214 consecutive patients with cT1-3N0 invasive breast cancer who had undergone intraoperative SLN evaluation at Songklanagarind Hospital between the 1stof March 2011 and the 30thof May 2016 were examined. Data on patient demographics, tumor variables and NLR were collected and factors for non-SLN metastasis were analyzed using multivariate logistic regression. The power of the NLR was quantified with receiver operating characteristics (ROC) curves as measured by the areas under curves (AUC). Results: Multivariate analysis established presence of lymphovascular invasion (OR 8.4, 95%CI 2.3-31.3, p=0.002), macrometastasis (OR 6.6, 95%CI 1.8-24.7, p=0.005), and NLR (OR 2.3, 95%CI 1.1-4.8, p=0.033) as predictive factors of non-SLN metastasis with statistical significance. The AUC for NLR was 0.7 (95%CI 0.6-0.8) with an optimal cut-off of 2.6 giving a sensitivity of 62%, a specificity of 83.8%, a positive predictive value of 77.3% and a negative predictive value of 70.5%. Conclusion: Pre-treatment NLR is a useful diagnostic aid for predicting additional non-SLN metastasis.     

早期宫颈癌淋巴结转移的高危因素分析及列线图预测模型的构建

 目的 探讨临床病理特征与早期宫颈癌淋巴结转移的关系，同时建立列线图模型预测只行根治性手术而未进行淋巴结清扫的早期宫颈癌患者淋巴结转移情况。方法 回顾性收集福建医科大学附属第一医院妇科432例行子宫切除及淋巴结清扫术并经病理组织学确诊的早期宫颈癌患者术后临床病理资料。运用Logistic回归分析确定早期宫颈癌淋巴结转移的高危因素。建立预测早期宫颈癌淋巴结转移风险的列线图模型，分别用一致性系数（C-index）和校准曲线评估模型的预测性能和符合度。结果 432例早期宫颈癌患者中，有84例患者出现转移，阳性率19.4%。多因素分析显示肿瘤最大径>3 cm、宫旁浸润、淋巴血管间质浸润是早期宫颈癌患者淋巴结转移的独立危险因素，其OR分别为1.98（95%CI:1.17~3.34）、2.64（95%CI: 1.28~5.44）、4.77（95%CI: 2.60~8.75）。用于预测淋巴结转移风险的列线图的准确度为0.687。结论 基于肿瘤最大径>3 cm、宫旁浸润和淋巴血管间质浸润构建的列线图，可用于指导只行根治性手术而未行淋巴结清扫的早期宫颈癌患者的进一步治疗。     

乳腺癌淋巴管生成与肿瘤转移的关系

目的：探讨乳腺癌肿瘤淋巴管生成与肿瘤转移的关系。方法：免疫组织化学SP法进行VEGFR-3染色标记89例原发性乳腺癌肿瘤淋巴管。结果：所有病例均有不同程度淋巴管生成，但以肿瘤间质组织中淋巴管生成为主，癌巢中未见明显的成形淋巴管。肿瘤淋巴管密度与乳腺癌临床分期和腋淋巴结转移呈正相关，临床分期越晚，肿瘤淋巴管密度越高（P〈0．05）；腋淋巴结转移组的肿瘤淋巴管密度比无淋巴结转移组高（P〈0．05）。结论：乳腺癌淋巴管密度与腋淋巴结转移呈正相关．淋巴管生成主要发生在肿瘤间质组织中。     

Immunostaining with D2–40 improves evaluation of lymphovascular invasion, but may not predict sentinel lymph node status in early breast cancer

Background  

Sentinel lymph node (SLN) biopsy is a widely used diagnostic procedure in the management of early breast cancer. When SLN is free of metastasis, complete axillary dissection may be skipped for staging in clinically N0 patients, allowing a more conservative procedure. Histological tumor features that could reliably predict SLN status have not yet been established. Since the degree of tumor lymphangiogenesis and vascularization may theoretically be related to the risk of lymph node metastasis, we sought to evaluate the relationship between lymph vessel invasion (LVI), lymphatic microvascular density (LVD), microvascular density (MVD) and VEGF-A expression, with SLN status and other known adverse clinical risk factors.     

Can Lymphatic Vascular Density Be Used in Determining Metastatic Spreading Potential of Tumor in Invasive Ductal Carcinomas?

Regional lymph node status is the primary parameter determining treatment strategies and prognoses in breast cancer. Lymphatic vessels in primary tumor tissue play a significant role in lymphatic metastasis. The aim of this study was to investigate the correlation of intra- and peritumoral lymphatic microvessel densities (LVD) with prognostic parameters in breast cancer, including lymphatic invasion (LI). Lymphangiogenesis was investigated using D2-40 monoclonal antibody in 69 invasive ductal carcinoma cases who underwent mastectomy and axillary lymph node dissection. Positively stained microvessels were counted at 400× in dense lymphatic vascular foci (hotspots). Tumor LI was established when at least one neoplastic cell cluster was clearly visible inside a D2-40-positive lymph vessel. Relationships were sought between clinicopathological parameters and mean LVD and LI in primary tumor tissue. Peritumoral LVD was markedly higher than intratumoral LVD (p < 0.001). No significant relationship was found between intratumoral LVD and clinicopathological parameters (p > 0.05). However, significant relationships were detected between peritumoral LVD and LVI [H&E] (p = 0.04), number of lymphatic invasion [n/mm2, D2-40] (p = 0.001), tumor size (p = 0.01), lymph node status (p = 0.03), and tumor stage (p = 0.04). The immunohistochemical determination of LI and LVD can contribute to the prediction of a tumor’s biological behavior in invasive ductal carcinomas. Peritumoral LVD in primary tumor tissue is closely related to parameters influencing the prognosis of a tumor.     

D2-40标记微淋巴管密度对乳腺癌淋巴结转移的临床意义

目的:探讨D2-40标识微淋巴管密度（mocro-lymphatic vessel density,MLVD）对于乳腺癌淋巴结转移的临床意义。方法:应用免疫组化SP法,对2010年6月-2012年12月43例乳腺癌标本进行淋巴管特异性标记物D2-40的检测,计数MLVD,分析其对腋窝淋巴结转移的临床意义。结果:D2-40标识MLVD与乳腺癌临床分期相关,淋巴结转移组MLVD明显高于淋巴结转移阴性组(P<0.05)。MLVD与临床分期相关,分期越晚周边MLVD越大。结论:D2-40标识乳腺癌MLVD对于乳腺癌淋巴结转移有一定的预测作用,具有良好的临床病理应用价值。     

胃癌中D2-40和CD34的表达及临床意义

目的 探讨D2-40和CD34在胃癌组织中的表达及D2-40阳性的淋巴管密度（LVD）和CD34阳性的微血管密度（MVD）与临床病理特征和预后的关系。方法 采用组织芯片和免疫组化技术检测108例胃癌和36例癌旁组织中D2-40和CD34的表达情况,并分别计数D2-40阳性的LVD和CD34阳性的MVD,分析两者与临床病理特征和预后的关系。结果 D2-40在胃癌和癌旁组织中的阳性表达率分别为85.2％（92／108）和22.2％（8／36）,差异有统计学意义（P=0.000）;CD34在胃癌组织中的阳性表达率为94.4％（102／108）,高于癌旁组织的36.1％（13／36）,差异有统计学意义（P=0.000）。胃癌组织中LVD和MVD计数分别为10.14±5.37和45.32±15.78,显著高于癌旁组织中的3.38±1.69和4.92±1.26,差异均有统计学意义（P均为0.000）;单因素分析显示两者与肿瘤大小、浸润深度、淋巴结转移、TNM分期有关,与性别、年龄无关。Cox多因素分析显示肿瘤大小、浸润深度、淋巴结转移、TNM分期及MVD和LVD是胃癌预后的独立影响因素。Kaplan-Meier生存分析显示,乏淋巴管组的中位生存时间为69.0个月（95％ CI：59.91～77.20个月）,高于富淋巴管组的33.0个月（95％ CI：23.20～42.66个月）;乏微血管组的中位生存时间为67.0个月（95％ CI：58.10～76.39个月）,高于富微血管组34.0个月（95％ CI：24.63～44.02个月）,上述差异均有统计学意义（P＜0.05）。结论 D2-40标记的LVD和CD34标记的MVD与胃癌的临床病理特征密切相关,有望成为胃癌发展及预后的预测指标。     

乳腺癌淋巴管生成与淋巴结转移、血管内皮生长因子-C表达的关系

目的 探讨乳腺癌中淋巴管生成的分布特点及与血管内皮生长因子-C(VEGF-C)的表达,淋巴结转移和预后的关系.方法 应用免疫组化方法检测70例乳腺癌组织VEGF-C蛋白的表达,并用淋巴管内皮细胞特异性抗体D2-40标记淋巴管,计数肿瘤淋巴管密度(LVD),结合临床病理特征和随访资料进行分析.结果 VEGF-C蛋白的高表达与淋巴结转移(P=0.010)、淋巴管浸润(P=0.031)呈正相关,与肿瘤组织学分级 (P＜0.001) 呈负相关.乳腺癌LVD与淋巴结转移(P＜0.001)、淋巴管浸润(LVI)(P=0.001)、VEGF-C表达(P=0.012)呈正相关,与无病生存率(P=0.011)及总生存率(P=0.001)呈显著负相关.多因素分析显示LVD是影响无病生存率(P=0.015)和总生存率(P=0.002)的独立因子.结论 乳腺癌组织中新生淋巴管主要分布于肿瘤间质,LVD与VEGF-C表达和癌细胞转移相关,乳腺癌微淋巴管密度测定对评估其淋巴结转移和预后判断可能具有意义.     

乳腺癌淋巴管密度的临床意义

目的探讨乳腺癌组织中淋巴管密度（LVD）与临床病理参数的关系。方法采用免疫组化方法对100例乳腺癌组织和20例乳腺纤维腺瘤组织中LYVE-1的表达进行检测,计数LVD,分析LVD与乳腺癌淋巴结转移及其它病理参数之间的相互关系。结果乳腺癌组织中LVD显著高于乳腺纤维腺瘤组织（P〈0.01）,有淋巴结转移的乳腺癌组织LVD显著高于无淋巴结转移者（P〈0.01）。LVD与年龄、肿瘤大小、ER、PR、c-erbB2无关（P〉0.05）,与病理分期显著相关（P〈0.01）。结论 LVD与乳腺癌的淋巴结转移有关,可作为乳腺癌淋巴结转移的生物学指标。     

Lymphatic and angiogenic characteristics in breast cancer: morphometric analysis and prognostic implications

Controversy exists regarding the topography of lymph vessels in breast cancer, their usefulness as prognostic factors, relationship with angiogenesis and whether active lymphangiogenesis occurs within the tumour. A series of 177 well-characterized breast cancers, with long term follow up, were stained with D2-40, CD31 and CD34. Distribution of lymphatics and lymph vessel density (LVD) were assessed in three areas, intratumoural, peripheral and peritumoural and correlated with clinicopathological criteria and patient prognosis. Microvessel density (MVD) was assessed and correlated with LVD. Double immunohistochemical staining with D2-40 and MIB-1 was carried out to assess the proliferative status of lymphatics and of the tumour emboli within. Peritumoural lymphatics were detected in all tumours whereas peripheral and intratumoural lymphatics were detected in 86 and 41% of specimens, respectively. Tumours with higher total LVD were significantly associated with the presence of lymph node (LN) metastasis and shorter overall survival (OS). In multivariate analysis, tumour grade, LN status and the presence of lymphovascular invasion, but not LVD, were independent poor prognostic factors. No association was found between LVD and MVD. Proliferating lymphatics were detected in 29% of specimens and were significantly associated with dense inflammatory infiltrate. In conclusion, lymphatics are located primarily in the peritumoural and peripheral areas in breast cancer and seem to play an important role in disease progression by being routes for tumour dissemination. The lack of correlation between lymphangiogenic and angiogenic characteristics suggests two distinct processes and the presence of active lymphangiogenesis, albeit in a small portion of specimens, may have important therapeutic implications.     

血管内皮生长因子C蛋白在乳腺癌组织中的表达及其意义

目的:研究血管内皮生长因子C(VEGF-C)蛋白在乳腺癌组织中的表达及意义。方法:采用免疫组化法对60例乳腺癌、12例良性乳腺病变组织中VEGF-C的表达进行检测,探讨其与微血管密度(MVD)、微淋巴管密度(MLD)、增殖细胞核抗原(PCNA)蛋白及临床病理因素之间的相关性。结果:乳腺癌组织中VEGF-C表达水平高于良性乳腺病变组织(u=137.5,P=0.001)。乳腺癌组织中VEGF-C表达与MVD无相关性(P=0.951),而与MLD(r=0.286,P=0.027)及PCNA(r=0.315,P=0.014)有相关性;VEGF-C(r=0.389,P=0.002)、MLD(r=0.335,P=0.009)与患者淋巴结转移状况相关,与其他临床病理因素无相关性。单因素Logistic回归分析显示,高VEGF-C、MLD组发生淋巴结转移的风险分别是低VEGF-C、MLD组的4.059倍(95%CI为1.234～13.349,P=0.021)和3.519倍(95%CI为1.209～10.240,P=0.021)。多因素Logistic回归分析显示,VEGF-C对淋巴结转移的影响独立于MLD。结论:乳腺癌组织中VEGF-C蛋白表达水平升高,VEGF-C在乳腺癌淋巴管生成及淋巴结转移中起重要作用,且它对淋巴结转移的影响独立于MLD。另外,VEGF-C高表达的患者肿瘤细胞的增殖性较强。     

早期胃癌淋巴管密度预测淋巴结转移的研究

目的:检测淋巴管内皮标志物D2-40计算早期胃癌淋巴管密度(LVD),探讨LVD与早期胃癌有无淋巴结转移之间的关系.方法:用免疫组化SP染色法,对80例早期胃癌淋巴结未发生转移与20例早期胃癌淋巴结发生转移的癌周检测D2-40标记阳性LVD的表达水平,并进行统计学分析.结果:D2-40标记阳性LVD在早期胃癌伴有淋巴结转移癌周高于早期胃癌不伴有淋巴结转移癌周(P＜0.05),光镜下LVD的截断(cut-off)值为18.50个.结论:早期胃癌伴有淋巴结转移癌周的LVD高于早期胃癌不伴有淋巴结转移癌周,D2-40阳性LVD可用来判断有无淋巴结转移.     

Tumor size as predictor of microinvasion, invasion, and axillary metastasis in ductal carcinoma in situ

Ductal carcinoma in situ (DCIS) represents a small number of cases in countries with inadequate breast cancer screening programs, and in the majority of cases is diagnosed as a palpable lump. It has been proposed that DCIS with palpable lump > or = 2.5 cm can be associated with microinvasion or invasive carcinoma and risk of axillary metastasis. The purpose of the present study is to evaluate incidence of microinvasion, invasion, and the role of lymphatic mapping and sentinel lymph node biopsy in DCIS > or = 2.5 cm.We conducted a retrospective analysis of patients with histologically proven incisional, excisional, or core biopsy of DCIS lump > or = 2.5 cm at a tertiary-care hospital. All patients underwent lymphatic mapping with sentinel lymph node biopsy.A total of 24 patients were included with average tumor size of 4 cm (range, 2.5-6 cm); 29% had microinvasive and 12.5% had invasive disease, three patients (12.5%) had positive sentinel lymph node, all had micrometastasis, and no metastasis were found in non-sentinel lymph nodes. Incidence of microinvasion and invasion were directly related with tumor size (10% for DCIS tumor size of 2.5-3.5 cm, 57% for 3.6-4.5 cm, and 71% for tumors between 4.5 and 6 cm). In addition, axillary metastasis incidence had a direct relationship with tumor size. (0% in 2.5-3.5-cm tumor size, 14% for 3.6-4.5 cm, and 28% in DCIS between 4.6 and 6.0 cm).The present study shows high incidence of microinvasion and invasion in DCIS diagnosed in tumors > or = 2.5 cm and supports the importance of axillary evaluation in patients with tumors >3.5 cm by means of lymphatic mapping and sentinel lymph node biopsy.     

Multi-kinase inhibitor E7080 suppresses lymph node and lung metastases of human mammary breast tumor MDA-MB-231 via inhibition of vascular endothelial growth factor-receptor (VEGF-R) 2 and VEGF-R3 kinase

PURPOSE: Vascular endothelial growth factor (VEGF)-C/VEGF-receptor 3 (VEGF-R3) signal plays a significant role in lymphangiogenesis and tumor metastasis based on its effects on lymphatic vessels. However, little is known about the effect of inhibiting VEGF-R3 on lymphangiogenesis and lymph node metastases using a small-molecule kinase inhibitor. EXPERIMENTAL DESIGN: We evaluated the effect of E7080, a potent inhibitor of both VEGF-R2 and VEGF-R3 kinase, and bevacizumab on lymphangiogenesis and angiogenesis in a mammary fat pad xenograft model of human breast cancer using MDA-MB-231 cells that express excessive amounts of VEGF-C. Lymphangiogenesis was determined by lymphatic vessel density (LVD) and angiogenesis by microvessel density (MVD). RESULTS: In contrast to MDA-MB-435 cells, which expressed a similar amount of VEGF to MDA-MB-231 cells with an undetectable amount of VEGF-C, only MDA-MB-231 exhibited lymphangiogenesis in the primary tumor. E7080 but not bevacizumab significantly decreased LVD within the MDA-MB-231 tumor. E7080 and bevacizumab decreased MVD in both the MDA-MB-231 and MDA-MB-435 models. E7080 significantly suppressed regional lymph nodes and distant lung metastases of MDA-MB-231, whereas bevacizumab significantly inhibited only lung metastases. E7080 also decreased both MVD and LVD within the metastatic nodules at lymph nodes after resection of the primary tumor. CONCLUSIONS: Inhibition of VEGF-R3 kinase with E7080 effectively decreased LVD within MDA-MB-231 tumors, which express VEGF-C. Simultaneous inhibition of both VEGF-R2 and VEGF-R3 kinases by E7080 may be a promising new strategy to control regional lymph node and distant lung metastases.     

乳腺导管癌演变过程中淋巴管密度变化的研究

目的:应用淋巴管内皮细胞抗体D2-40单克隆抗体(mab)检测乳腺导管癌演变中淋巴管密度(LVD)变化.方法:选取乳腺不典型导管增生(ADH)、导管内癌(DCIS)和微浸润癌(MDC)各20倒,浸润性导管癌(IDC) 50例,采用免疫组织化学SP法检测各组的D2-40表达,光镜下选择3个淋巴管丰富区域,并在200倍视野下进行LVD计数.结果:D2-40标记的LVD在乳腺ADH 、DCIS、MDC及IDC瘤周中分别为5.00±1.78、5.35±1.98、5.80±2.71和14.62±3.48,差异有统计学意义,P＜0.05.进一步行LSD检验发现,ADH、DCIS和MDC 3组间差异无统计学意义,P＞0.05.结论:在直至MDC阶段,乳腺癌通过淋巴管转移的风险低;但IDC阶段,D2-40标记的LVD显著增加、转移风险增加以及LVD的多少可能成为鉴别乳腺癌微浸润还是浸润的参考指标,为乳腺癌脉管转移的预防和治疗时机选择提供相关理论依据.     

直肠良恶性肿瘤中肿瘤相关巨噬细胞和微血管及淋巴管生成的关系

目的:探讨直肠良恶性肿瘤组织中微血管密度(MVD)及淋巴管密度(LVD)与肿瘤相关巨噬细胞(TAMs)数量的相关性。方法:采用免疫组化的方法,用CD68标记TAMs,分别用CD31和D2-40标记微血管和淋巴管,光镜下对TAMs,MVD及LVD进行计数,分析。结果:直肠腺癌组织中的TAMs,MVD及LVD计数明显高于直肠腺瘤型息肉组织(P<0.01);在直肠腺癌组中,TAMs与MVD和LVD有明显相关性(TAMs与MVD:P<0.01;TAMs与LVD:P<0.01),且MVD与直肠癌淋巴结转移(P<0.01)和分化程度(P<0.05)密切相关;而TAMs和LVD仅与淋巴结转移有显著相关性(P<0.01,P<0.05)。结论:TAMs,MVD及LVD可能是反映直肠腺癌发生、发展、转移及侵袭能力的生物学指标,TAMs在肿瘤中的浸润可能与肿瘤血管及淋巴管的生成有关。     

乳腺癌腋窝淋巴结转移血管生成的免疫组化研究

目的　研究乳腺癌腋窝淋巴结转移的血管生成情况。方法　采用内皮细胞ⅧFRAg 免疫组化染色技术,对37 例乳腺癌根治术或改良根治术切除的乳腺癌组织和121 枚腋窝转移淋巴结进行免疫组化染色。在100 倍视野下通过显微电视系统计数微血管密度( MVD) ,并用显微测量器测量转移灶的直径。结果　在121 个淋巴结中找到13 处微转移灶,其平均直径为(210 ±37) μm ,无血管生成。腋窝淋巴结转移瘤的MVD 为89-3 ±18-4 ,与乳腺癌组织MVD(93-8 ±21-8) 差异无显著性,且微血管分布不均,周围高于中央。结论　淋巴结微转移灶无血管生成,转移瘤有血管生成。为抑制微转移灶发展成转移瘤,以及抑制转移瘤的生长,抑制血管生成可能是控制淋巴结转移的有效措施。