乳腺癌血管生成及组织蛋白酶D表达与转移的关系

Correlation of angiogenesis and expression of cathepsin D with metastasis in invasive breast cancer

目的：探讨乳腺癌组织微血管密度（ｍｉｃｒｏｖｅｓｅｌｄｅｎｓｉｔｙ，ＭＶＤ）及组织蛋白酶Ｄ（ｃａｔｈｅｐｓｉｎＤ，ＣＤ）表达与转移的关系。方法：应用免疫组织化学方法对乳腺癌组织的ＭＶＤ及ＣＤ进行定量和半定量研究。结果：乳腺癌组织ＭＶＤ及ＣＤ表达与淋巴结转移密切相关，腋下淋巴结转移组的ＭＶＤ（１３１．８±３９．８）明显高于腋下淋巴结阴性乳腺癌（ｎｏｄｅｎｅｇａｔｉｖｅｂｒｅａｓｔｃａｎｃｅｒ，ＮＮＢＣ）组的ＭＶＤ（７８．１±２７．１）（Ｐ＜０．００１）；腋下淋巴结转移组ＣＤ高表达者（３３／３６，９１．７％）明显多于ＮＮＢＣ组（１６／３６，４４．４％）（Ｐ＜０．０１）。乳腺癌组织ＭＶＤ与ＣＤ表达关系密切；远处转移及早期死亡者ＭＶＤ较高且ＣＤ表达极强。结论：乳腺癌组织ＭＶＤ的增加及ＣＤ高表达可能协同促进肿瘤转移。富于微血管及ＣＤ高表达的乳腺癌应作为远处转移及早期死亡的高危患者加以重视。

Purpose To explore correlations between microvessel density (MVD) and expression of cathepsin D (CD) and metastasis. Methods Microvessels and CD was immunostained by standard ABC method. The results were analyzed statistically with t test and chi square test. Results MVD and CD expression was correlated well with lymph node status. The mean MVD (131 8±39 8) of lymph node positive cases was significantly higher than that (78 1±27 1) of node negative breast cancers (NNBCs) ( P< 0 001). High level of CD expression was less frequently found in NNBCs ( P< 0 001). Metastatic foci in the lymph nodes of all the node positive cases expressed high level of CD. Those with distant metastasis and early death were highly vascularized and rich in CD. Good correlation of MVD with CD expression was also noted in this study. Conclusion High blood vessel counts and high level of CD expression may synergistically facilitate metastasis of breast cancer. Highly vascularized and CD riched breast cancers may be at high risk of distant metastasis and early death and may benefit from aggressive adjuvant therapy and close surveillance.