乳腺癌X线特征与VEGF-C表达及肿瘤腋窝淋巴结转移的相关性研究

Value of Digital Mammography Combined with VEGF C to Evaluate the Axillary Lymph Node Metastasis in Patients with Breast Carcinoma

目的研究乳腺癌X线征象与肿瘤组织血管内皮生长因子-C(VEGF-C)表达及腋窝淋巴结转移的相关性。资料与方法分析105例乳腺癌及腋窝淋巴结的X线征象,利用免疫组织化学染色检测标本中VEGF-C的表达水平,分析乳腺癌某些X线征象与VEGF-C表达及腋窝淋巴结转移的关系。结果VEGF-C的过表达与腋窝淋巴结转移密切相关(P<0.05);乳腺癌X线征象中:肿瘤≥2cm、边缘有"毛刺征"及血管影增多、增粗组中VEGF-C阳性表达率及腋窝淋巴结转移率分别较<2cm、无"毛刺征"和血管影正常组高(P<0.05);转移性腋窝淋巴结主要表现为"门"结构消失及实质厚度不均匀(P<0.05)等。结论通过乳腺癌的X线征象可以评价其组织中VEGF-C的表达水平及腋窝淋巴结的状态,乳腺癌腋窝淋巴结转移主要表现为淋巴结结构的改变,当腋窝淋巴结发生实变、实质厚度不均时,可疑为转移性淋巴结。X线对判断乳腺癌腋窝淋巴结转移有明显优势。

Objective To investigate the relationship between the expression of vascular endothelial growth factor-C （VEGF C） and axillary lymph node（LN） metastasis with breast cancer mammography sign. Materials and Methods Digital mammography features of 105 patients with primary breast cancer were analyzed retorspectively. VEGF C was measured in tumor specimens with immunohistochemical method of SP. Analysis the relationship between the expression of VEGF C and LN metastasis of breast cancer. Results The excessive expression of VEGF C had closely correlated with axillary lymph node （LN） metastasis （P 〈 0.05 ）. The ratio of axillary LN metastasis in the tumors larger than 2 cm was higher than those of less than 2cm （ P 〈 0.05 ）. The positive expression rate of VEGF C and the ratio of LN metastasis in the tumors larger than 2 cm, speculated margin of mass and more vascular signs group were higher than those without spiculation （P 〈 0.05 ）. The main features of axillary LN metastasis were lymp node hilar and irregular cortex losing （ P 〈 0.05 ）. Conclusion Breast cancer mammography sign can evaluate the expression of VEGF C and axillary LN metastasis. The main features of axillary LN metastasis is the structure change. The abscent of the hilar and the irregular cortex of the axillary LN in patients with breast cancer are probably indicative of metatasis. The digital mammography is the modalityof choice for the assessment of axillary LN in patients with breast cancer.