乳腺癌血管生成相关因素的检测及意义

目的　探讨检测乳腺癌组织血管生成相关因素及其临床意义。方法　采用能量多普勒检测 80例乳腺癌内血流信号并通过图像分析技术定量测定肿瘤内血管阳性反应总面积 ,同时采用免疫组化技术进行血管内皮生长因子 (VEGF)测定和肿瘤内微血管密度 (MVD)计数。结果　乳腺癌组织中VEGF表达阳性率为 44 .4% ,VEGF阳性病例血管阳性反应总面积、MVD值高于阴性病例 (P <0 .0 1) ,三者与一般临床病理因素无关 ,但与组织学分级及腋窝淋巴结转移密切相关。VEGF阳性表达者五年生存率 ( 3 9.4% )明显低于阴性表达者 ( 76.1% ) (P <0 .0 1)。结论　PDI定量检测肿瘤血管阳性反应总面积与MVD计数、VEGF测定相结合 ,能全面反映肿瘤血管生成状态。VEGF阳性表达者血管生成活跃 ,肿瘤血管阳性反应总面积、MVD值高 ,其预后差。

Correlation between Tumor Angiogenic Activity and Its Significance in Primary Breast Carcinoma

Objective To study the relationship between tumor angiogenesis and its significance. Methods Intratumoral vascularization in 80 cases of breast cancer was observed preoperatively by power Doppler imaging (PDI) and analysed with computer assisted quantative assessment,and the expression of microvessel density (MVD) and VEGF protein were determined by immunohistochemical technique. Results 44.4% of the breast carcinoma was VEGF positive. Blood vessels postitive area and MVD in VEGF positive cases were higher than those of the negative ( P <0.01). All of them were not correlated with the clinicopathological factors but associated with histological grade of differentiation and axillary lymph node metastasis,whereas,negatively correlated with the five year survival rate ( P <0.01). Conclusion Power Doppler imaging (PDI) quantative assessement integrated with immunohistochemical S P method and the Weidner's method can observe intratumoral vascularization overall. Blood vessels postive area,microvessel density (MVD) and the expresssionOf VEGF may be good prognostic indicators for the patients with breast carcinoma.