彩色多普勒能量图(CDE)检测乳腺癌血管生成活性与MVD相关性研究及其与转移的关系

THE COHERENT STUDY ON THE RELATIONSHIP BETWEEN ANGIOGENESIS,MICROVESSEL DENSITY(MVD) AND TUMOR METASTASIS IN BREAST CARCINOMA BY COLOR DOPPLER ENERGY(CDE)

目的:研究血管生成活性与肿瘤转移的关系,探讨彩色多普勒超声预测乳腺癌预后的应用价值。方法:43例乳腺癌病例,腋淋巴结转移即阳性组17例,腋淋巴结无转移即阴性组26例。分别于术前行彩色多普勒超声检查,检测肿瘤特性。于术后以CD 34单克隆抗体作其病理组织切片的免疫组织化学染色,在显微镜下进行微血管计数即微血管密度(M VD)。计量资料采用t检验,计数资料采用χ2检验及秩和检验。结果:(1)阳性组乳腺癌组织的M VD值(49.2±25.5)(个/100倍)高于阴性组乳腺癌组织的M VD值(32.1±14.4)(个/100倍),二者差异具有显著性意义(P<0.05);随着组织学级别的增加,乳腺癌组织的M VD值显著增大(P<0.05)。(2)CDE显示肿块血流信号阳性组较阴性组丰富,且与其组织学分级及腋淋巴结转移率有关。随着组织学级别的增加,肿块内血流信号丰富程度有增加的趋势;随着肿块血流信号的增多,其腋淋巴结转移率有增大的趋势,至Ⅳ型时显著性增大(P<0.05)。结论:乳腺癌的血管生成活跃者,其腋淋巴结转移的可能性大。彩色多普勒能量图(CDE)技术的运用,有可能为临床预测乳腺癌预后提供简便、直观的形态学依据。

Objective： To study the relationship between angiogenesis and tumor metastasis and to evaluate the prognostic value of color Doppler energy （CDE） in primary breast carcinoma. Methods： Intratumoral vascularization was observed before operation by CDE on 43 patients with breast carcinoma （17 breast carcinoma cases with axillary-node-positive and 26 cases with axillary-node-negative）, and the microvessel density （MVD） was measured after operation by immunohistochemical staining of their formalin-fixed paraffin-embedded tissue sections with monoclonal antibody CD34. Then, the relationship between angiogenesis and lymph node metastasis were studied furtherly. Results： （1）MVD （49. 2±25. 5） of breast carcinoma was higher in axillary-node-positive group than MVD （32. 1±14. 4） in axillarynode-negative group （P〈 0. 05）; With the increase in histologic grade of masses, MVD expression of tumor was higher （ P 〈0. 05）. The lymph node metastasis was not related to two-dimentional ultrasound features of masses. （2）CDE examination suggested that the blood flow signals of intratumor were more in axillary-node-positive group than in axillary-nodenegative group, and they had a tendency to increase with the rise of the histologic grade of breast cacinoma. Conelusion： Angiogenesis is closely related to metastasis in breast carcinoma, which may serve as a prognostic factor to predict tumor metastatic potential and prognosis.