乳腺癌中VEGF-C mRNA的表达与淋巴结微转移的关系

Relationship between VEGF-C mRNA expression and micrometastases in breast carcinoma

目的探讨腋淋巴结阴性(axillary node negative,ANN)乳腺癌中VEGF-C mRNA的表达与淋巴结微转移的关系及临床意义。方法随机抽取乳腺浸润性导管癌139例,在组织芯片上用原位杂交方法检测VEGF-C mRNA表达;用免疫组化EnVision法检测广谱角蛋白(AE1/AE3)在ANN组淋巴结中的表达,以判定微转移;同时检测ER、ki67和cerbB-2蛋白在肿瘤组织中的表达情况。结果VEGF-C mRNA在腋淋巴结阳性(axillary node positive,ANP)组中的表达(53.0%)显著高于ANN组(27.4%)(P=0.001 1)。ANN组中,有14例患者腋窝淋巴结发现微转移灶,微转移率为19.2%(14/73);有微转移的患者其原发灶中VEGF-C mRNA表达率(50.0%)高于同组无微转移患者(22.4%)。差别具有统计学意义(P=0.038 6)。ANN组中VEGF-C mRNA表达与肿块大小(临床分期)、组织学分级正相关;与ER、ki67和cerbB-2蛋白表达及患者年龄无关。结论在ANN乳腺癌患者中VEGF-C mRNA的表达与淋巴结微转移密切相关。检测癌组织中VEGF-C mRNA的表达可能为预测ANN乳腺癌患者淋巴道转移和微转移提供有用的观测指标。

Objective To study the expression of vascular endothelial growth factor-C （VEGF-C） mRNA in axillary-node-negative （ANN） breast carcinoma and its relationship with micrometastasis in axillary lymphnode and its clinical significances. Methods A tissue microarray/tissue chip was constructed to contain 139 formalin fixed paraffin embedded invasive-ductal-carcinoma tissue samples of breast. Expression of VEGF-C mRNA was investigated by in situ hybridization in 139 cases breast cancer. The lymph nodes micrometastasis was examined by monoclonal antibodies against cytokeratin （AEI/AE3）. The expression of ER,Ki67 and cerbB-2 were detected by immuohistochemically EnVision method. Results The expression of VEGF-C mRNA in axillary lymph node positive （ANP） group （53.0%） was siginficantly higher than in ANN group（27.4% ）（P = 0.001 1 ）. In ANN group, micrometastasis of lymph nodes were detected in 14 cases, micrometastasis rate being 19.2% （14/73）. A significant difference was found between lymph node micrometastasis positive group and lymph node micrometastsaes negative group in the expression of VEGF-C mRNA （50.0%, 22.4% ） （ P = 0.038 6）. The expression of VEGF-C mRNA was not correlated with age and the expressions of ER, cerbB-2and Ki67; but correlated significantly with the tumor size （clinical stage）, histological stage （ P 〈 0.05 ）. Conclusion A close correlation is found between VEGF-C mRNA expression and lymph node micrometastasis in ANN breast carcinoma. It is helpful for predicting the risk of micrometastasis and metastasis with ANN by examining the expression of VEGF-C mRNA.