乳腺癌周微淋巴管密度与腋淋巴结转移的相关性研究

Study between axillary lymph node metastasis and density of lymphatic microvessel in the tissue adjacent primary breast carcinoma

目的探讨乳腺癌癌周组织中微淋巴管的密度与腋窝淋巴结转移之间的相关性。方法应用免疫组化的方法,采用Ⅷ因子、Ⅳ型胶原及VEGFR-3单抗将67例Ⅱ期乳腺癌癌周组织中微淋巴管和微血管加以区别。并用装有10X10网格的目镜,在200倍光镜下对染色阳性的微内皮管计数。结果在36例腋窝淋巴结转移组中,乳腺癌周组织的微淋巴管密度是(6.33±0.37)/HPF(×200),在31例非转移组中,癌周组织的微淋巴管密度是(2.81±0.30)/HPF(×200),(P<0.001);转移组的微血管密度是(19.75±0.47)/HPF(×200),非转移组微血管密度是(25.65±0.81)/HPF(×200),(P<0.001);相关性分析显示:癌周组织Ⅷ因子染色微管密度与腋窝淋巴结转移无相关性(r=-0.040,P>0.05),Ⅳ型胶原染色的微血管密度与腋窝淋巴结转移之间成负相关(r=-0.844,P<0.001),VEGFR-3染色的微淋巴管密度与腋窝淋巴结转移成正相关(r=0.841,P<0.001)。结论乳腺癌腋淋巴结转移状态不同,其癌周组织中微淋巴管密度差异有显著性;乳腺癌癌周微淋巴管密度越高,腋窝淋巴结转移的可能性越大。

[Objective] To analyse the interrelation between axillary lymph node metastasis and the density of lymphatic microvessel in the tissue adjacent primary breast carcinoma. [Methods] Immunohistoehemisty was employed to differentiate lymphatic microvessel from blood microvessel in 67 samples from patients with primary breast carcinoma （stage T2） by means of mono-antibodies of factor Ⅷ, typeⅣcollagen and VEGFC-R. [Results] The densities of lymphatic microvessel in the tissue adjacent primary breast carcinoma in lymph node metastasis group （LNM group, 36 cases） and non-lymph node metastasis group （NLNM group, 31 cases） were （6.33±0.37）/HPF （×200） and （2.81±0.31）/HPF （×200） respectively （P 〈0.001）; and that the densities of blood microvessel in the tissue adjacent primary breast carcinoma in LNM group and NLNM group were （19.75±0.47）/HPF （×200） and （25.65±0.81）/HPF （× 200） respectively （P 〈0.001）. The result of interrelation analysis showed that there was not any relationship between the density of microvessel positively stained by factor Ⅷ in the tissue adjacent primary breast carcinoma and the rate of axillary lymph node metastasis （r =-0.040, P 〉0.05）; there appeared a negative relationship between the density of blood microvessel positively stained by type lV collagen in the tissue adjacent primary breast carcinoma and the rate of axiUary lymph node metastasis （r =-0.844, P 〈0.001）; and there was an positive relationship between the density of lymphatic microvessel positively stained by VEGF-C in the tissue adjacent primary breast carcinoma and the rate of axillary lymph node metastasis （r =0.841, P 〈0.001）. [Conlusion] According to the different status of axillary lymph node, the density of lymphatic microvessel in the tissue adjacent primary breast carcinoma exists obvious difference. The higher the density of lymphatic microvessel in the tissue adjacent primary breast carcinoma is, the more possibly the axillary lymph node metastasis occurs.