声学造影对腋淋巴结阴性乳腺癌血管生成的定量检测及生物学行为相关性研究

目的探讨超声造影对腋淋巴结阴性乳腺癌（ANNBC）血管生成的定量检测及与其生物学行为的关系。方法采用超声造影结合能量多普勒技术术前检测60例ANNBC患者肿瘤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,采用免疫组织化学技术检测肿瘤内微血管密度（MVD）的表达,分析造影前后肿瘤内血管阳性反应总面积与MVD的相关性,单因素和多因素方法研究造影后肿瘤内血管阳性反应总面积、MVD与ANNBC相关临床病理因素及预后的关系。结果全部病例造影增强前PDI检测血管阳性反应总面积与MVD无相关性（r=0.25,P〉0.05）,造影增强后血管阳性反应总面积与MVD呈正相关（r=0.65,P〈0.05）。造影增强后血管阳性反应总面积、MVD均与一般临床病理因素无关,与组织学分级和复发转移密切相关,术后复发转移组造影增强后血管阳性反应总面积、肿瘤内MVD均显著高于无瘤生存组。高血管阳性反应总面积组及高MVD组总生存率（OSR）和无瘤生存率（DFSR）低于低血管阳性反应总面积组和低MVD组（P〈0.005）。结论超声造影结合能量多普勒技术对ANNBC血管生成活性的定量检测可作为有价值的预后预测指标及治疗指导指标。

Contrast ultrasound for evaluating tumor angiogenic activity and its prognostic significance in axillary-node-negative breast carcinoma

Objective To determine the value of contrast ultrasound for evaluating tumor angiogenic activity and its prognostic significance in axillary-node-negative breast carcinoma. Methods Intratumoral vascularization was observed preoperatively by power Doppler imaging (PDI) before and after the injection of contrast agents and analyzed with computer-assisted quantitive assessment, and the microvessel density (MVD) were also assessed immunohistochemicaly by using the specific endothelial cell markers FVIII-RA. Correlations between blood vessels positive area within masses, the expression of MVD and several clinic pathologic factors were studied further. Results Before using contrast agents, there was no correlation between the blood vessels positive area and the expression of MVD. After contrast enhanced PDI was performed, it showed positive correlation between them. Both of them were not correlated with the general clinic pathologic factors. Blood vessels positive area and MVD were significantly higher in tumors relapsed or metastasis group than in disease free survival group. Moreover, patients with higher blood vessels positive area or higher MVD had lower disease free survival rate (DFSR) or overall survival rate (OSR) than those with lower blood vessels positive area or lower MVD. Conclusion Blood vessels positive area or MVD may be good prognostic indicators for patients with ANNBC which are useful in selection of high-risk ANNBC patients for adjuvant therapy or antiangiogenic therapy.