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。

Im munohistochemical study of angiogenesis of axillary lymph node metastasisin human breast carcinoma

OBJECTIVE: To study angiogenesis of axillary lymph node metastases (including micrometastatic foci and metastatic tumors) in breast carcinoma and the relationship between microvessel density (MVD) and metastasis. METHODS: Thirty-seven breast cancer tissues and 121 metastatic axillary lymph nodes were collected from breast cancer patients and studied immunohistochemically. MVD was counted by means of microvideo system under 100x magnification. The diameter of each micrometastasis was measured with a micrometer. RESULTS: The mean diameter of 13 micrometastatic foci was 210 +/- 37 microns. No blood vessel formation was found. MVD of the primary tumor and that of metastatic tumor in the axillary lymph node was 93.8 +/- 21.8 and 89.3 +/- 18.4, respectively (P > 0.05). The distribution of microvessels of the metastatic tumor in the lymph node and that of the primary tumor was similar, being higher at the periphery than at the center. CONCLUSION: Micrometastatic foci of breast carcinoma in the axillary lymph node do not have new blood vessel formation. Their further growth, however, depends on neo-angiogenesis. Treatment based on inhibition of angiogenesis may be efficacious in the prevention of micrometastatic foci from developing into metastatic tumor in lymph node.