乳腺癌微血管密度和血管内皮生长因子表达的临床意义

Clinical significance of microvessel density and vascalar endothelial growth factor in primary breast cancer

目的观察乳腺癌组织中微血管密度(Microvesseldensity,MVD)和血管内皮生长因子(Vascalarendothelialgrowthfactor,VEGF),分析其与临床病理特征的关系及对预后的影响。方法采用免疫组织化学方法检测47例手术切除的乳腺癌组织中MVD和VEGF,并与临床病理特征及预后进行统计分析。结果①乳腺癌组织中200倍视野内MVD计数范围为21￣89,平均为43.13±15.40,中位数为42;VEGF在乳腺癌组织中的阳性表达率为59.6%(28/47例);②MVD计数和VEGF表达阳性率与淋巴结转移均密切相关(P<0.05);复发转移者较无病生存者MVD和VEGF表达明显增加(P<0.05),而与月经状况、组织分级和激素受体状况无关(P>0.05);③VEGF阳性表达乳腺癌的MVD高于VEGF阴性表达的MVD,两者间有显著性差异(P<0.001);④Kaplan-Meier生存分析结果表明:高MVD(>42)和低MVD(≤42)、VEGF表达阴性和阳性两组总生存期(overallsurvival,OS)和无病生存期(diseasefreesurvival,DFS)比较均有显著性差异(P<0.05)。结论MVD和VEGF与淋巴结的转移数目、复发转移状态、无病生存期和总生存期相关,有可能成为乳腺癌另一预后预测因素。

Objective To investigate the relationship between microvessel density （MVD） and Vascalar endothelial growth factor （VEGF）, clinicpathological characteristics and the prognosis in primary breast cancer patients. Methods MVD and VEGF in 47 cases of breast cancer were studied by immunohistochemistry on formalin-fixed, paraffin-embedded tumor section. Correlations between MVD, VEGF, clinicpathological factors and prognosis were statistically analyzed. Results ①The mean of MVD was 43.13±15.40, range 21-89, median 42 in all patients. VEGF expression was observed in 28 of 47 （59.6%）. ②MVD and VEGF were statistically significantly higher in lymph node positive, and relapsed or metastatic group than in lymph node negative and disease free survival group （P〈0.01）, whereas no correlations with menopausal status, histologic grade, estrogen receptor and progesterone receptor （P〉0.05）. ③The MVD of the VEGF positive cases in breast cancer was significantly higher than that of the VEGF negative case （P〈0.001）. ④Kaplan-Meier survival analysis indicated that both overall survival （OS） and disease free survival （DFS） statistically significantly between low-MVD and high-MVD group, or between VEGF expression negative and VEGF expression positive, respectively. Conclusion MVD and VEGF were relationship with lymph node positive number, relapsed or metastatic status, DFS and OS. It could be an independent prognostic factor in primary breast cancer.