乳腺癌组织中微淋巴管分布及密度的临床病理意义

CLINICOPATHOLOGICAL SIGNIFICANCE ON DISTRIBUTION AND DENSITY OF MICROLYMPHATIC VESSEL IN BREAST CARCINOMA

目的探讨乳腺癌组织中微淋巴管分布、密度及其与相关临床病理因素之间的关系,分析乳腺癌淋巴结转移的可能机制。方法应用免疫组化SABC法检测50例乳腺癌及其相应癌旁正常乳腺组织中D2-40的表达,并分别计数其微淋巴管密度(microlymphatic density,MLD)。结果乳腺癌组织中的MLD明显高于癌旁正常组织(P<0.01),且肿瘤不同区域中MLD有所差异,肿瘤边缘区MLD均值显著高于癌旁正常组织及肿瘤中心区均值(P<0.01);肿瘤中心区MLD与正常组织MLD无显著性差异(P>0.05);肿瘤边缘区MLD与乳腺癌的临床分期、淋巴结转移状态相关(P<0.01),与年龄、肿瘤大小、组织分型及雌、孕激素受体状态无关(P>0.05)。结论1)乳腺癌组织中存在淋巴管,且分布存在异质性,淋巴管主要分布于肿瘤边缘区,肿瘤边缘区MLD与淋巴结转移、临床分期状态相关,其MLD的增加可能与乳腺癌的侵袭及转移相关;2)乳腺癌组织中的MLD检测可作为评估乳腺癌淋巴结转移状况的一项辅助指标,为判断乳腺癌患者预后及确定临床治疗方案提供实验和理论依据。

Objective To investigate the characteristics of distribution and density of lymphatic vessel and the correlation with its clinicopathological factors in breast cancer and analyse the possible mechanism of lymph node metastasis in breast carcinoma. Methods Making use of immunohistochemistry to research the expression of D2 - 40 in 50 cases of breast carcinoma and the normal tissues near the tumor borderline ,which microlymphatic density was counted. Results The MLD in breast carcinoma was significant higher than that in the normal tissue adjacent carcinoma（ P 〈0.01 ） and it was not the same in different aeras of carcinoma . The MLD in tumor borderline was higher than that in the normal tissues and tumor center tissues （P 〈0.01 ）and There was no correlation in the tumor center and the normal tissue （ P 〉 0.05 ）. The MLD in the borderline had positive relation to the clinical stage, and lymph node metastasis （ P 〈 0.01 ）, but it had no significant difference from age, tumor diameter, histologic types , progestoger and estrogen receptor condition （ P 〉 0.05 ）. Conclusions 1. The lymphatic vessel appears in the breast carcinoma. It mainly distributes in the tumor borderline. The MLD in the tumor borderline has correlation with clinical stage ,lymph node metastasis. The increase of MLD may be related to the invasion and metastasis of breast carcinoma in the tumor borderline. 2. The detection of MLD in the tissue of breast carcinoma can be a important affiliated markers to evaluate the lymph node metastasis. It also can measure the prognosis of breast carcinoma and provide experimental and theoretical foundation to confirm the clinical treatment methods.