人乳腺癌中D2-40标记的微淋巴管密度与淋巴结转移关系的研究

Relationship of Lymphatic Microvessels Marked by Monoclonal Antibody D2-40 with Metastasis of Lymph Nodes in the Tissues of Human Breast Cancer

目的:探讨人类乳腺癌组织中D2-40标记的微淋巴管的形态特征及微淋巴管密度(Lymphatic microves-seldensity,LMVD)与乳腺癌淋巴结转移的关系。方法:收集沈阳军区总医院2003年1月～2006年10月手术切除的乳腺癌术后组织石蜡标本102例,另选取乳腺纤维腺瘤标本25例为对照组。采用单标及双标免疫组织化学法分别检测D2-40和CD31的表达,计数D2-40阳性微淋巴管密度(LMVD),分析其与乳腺癌淋巴结转移的关系。结果:102例乳腺癌组织中D2-40阳性率为76.5%(78/102),25例对照组D2-40阳性表达率为24.0%(6/25),显著低于乳腺癌组织(χ2=24.685,P=0.000)。102例浸润性乳腺癌组织中D2-40阳性的微淋巴管中位LMVD为21.61(19.72±5.11)个微淋巴管/100倍视野,且癌周组织中位LMVD显著高于瘤内(P<0.05)。单因素方差分析和Pearson相关性分析显示腋淋巴结转移数目和乳腺癌瘤周D2-40标记淋巴管密度有关(P<0.01,r=0.964),而与瘤内D2-40标记的淋巴管密度无统计学相关(P>0.05)。结论:D2-40可以特异性标记乳腺癌组织中微淋巴管内皮细胞,其标记的癌周微淋巴管密度与乳腺癌的淋巴结转移数目密切相关,因此抑制癌周微淋巴管生成有望成为抗肿瘤治疗新的靶点。

Objective： To investigate the morphologic characteristics of micro-lymphatic vessels marked by D2-40 in human breast cancer and to analyze the correlation with metastasis of lymph nodes. Methods： A total of 102 cases of breast cancer and 25 cases of breast fibro-adenoma （control group） were collected and all of them underwent surgery in our hospital from January 2003 to October 2006. The expression of D2-40 and CD31 in lymphatic microvessels was evaluated by single-labeling or double-labeling immunohistochemistry. The lymphatic micovessel density （LMVD） was calculated. The relationship of LMVD with the state of lymph node metastasis was analyzed. Results： The positive rate of D2-40 in the 102 breast cancer cases was 76.5% （78/ 102）. The positive rate of D2-40 in the control group was 24% （6/25）, obvious lower than that in the breast cancer group （x^2=24.685, P=-0.000）. The median LMVD in the 102 cases of breast cancer was 21.61 （19.72± 5.11） lymphatic microvessels per × 100 field visually, significant higher than that in the control group [5.10 （7.10 ± 3.72） lymphatic microvessels per × 100 field visually] （t=2.561, P=0.017）. Moreover, the LMVD in the peripheral region of breast cancer was significant higher than in the intratumoral region （P〈0.01）. The statistical results of one-way ANOVA and Pearson Correlation suggested that the number of lymphatic nodes infiltrated by tumor cells was correlated with LMVD in the peripheral region of breast cancer, but was not correlated with the LMVD in the intratumoral region （P〈0.01, r=0.964）. Conclusion： In human breast cancer, new monoclonal antibody D2-40 can specifically mark the lymphatic endothelial cells. The positive lymphatic microvessels, especially in the peripheral region, are correlated with the lymphatic metastasis of breast cancer, indicating that the suppression of micro-lymphatic vessels may become a new choice of tumor therapy.