乳腺癌相关淋巴水肿与VEGF-C及VEGFR-3的关系

Relationship between breast cancer-related lymphoedema and VEGF-C and VEGFR-3

目的研究探讨乳腺癌组织中VEGF-C及癌周淋巴管密度（peritumoral lymph vessels density，PLVD）的表达和分布情况及其临床病婵学特征，初步探讨其与乳腺癌相关淋巴水肿（breast cancer-related lymphoedema，BCRL）发生间的关系：方法应用免疫组化技术检测47例乳腺癌组织中VEGF-C及VEGFR-3，观察乳腺癌组织中VEGF-C的表达情况并计数，检测患者双侧上肢周径，判断有无水肿并分级。结果47例乳腺癌组织中VEGF-C阳性表达者33例，VEGF-C阳性组的PLVD（30．39±10．46）较阴性组（23．16±11．67）明显增高（P〈0．05）。癌组织内VEGF—C半定量评分与PLVD呈正相关（r=0．334）。淋巴结转移组VEGF—C的阳性表达率（42．55％）及半定量评分（3．68±1．59）均高于未转移组（27．66％，2．48±2．31）（P〈0．05）；淋巴结转移组PLVD高于未转移组（32．12±10．29VS．24．82±11．06），P〈0．05。47例患者中一年内发生BCRL者17例，一年后仍有BCRL的8例。VEGF—C阴性组发生水肿者（5／14）较阳性组（3／33）增加（P〈0．05）。结论VEGF—C在乳腺癌组织中有较高的阳性表达率，并且与PLVD呈正相关。乳腺癌组织中VEGF—C高表达可减少BCRL发生的机会。

Objective To study the distribution and clinicopathologieal characteristics between VEGF-C and peritumoral lymph vessels density （PLVD） in breast cancer tissue, and to investigate the development and the mechanism of breast cancer-related lymphoedema （BCRL）. Methods VEGF-C and VEGFR-3 were detected by using immunohistochemical technique for the detection of VEGF-C and its receptor VEGFR-3 in forty-seven breast cancer specimens. We measured the patients＇ circumferences of bilateral upper limbs to determine whether there was lymphoedema and made classification in the follow-ups. Results VEGF-C was positive in 33 out of 47 cases. PLVD significantly increased in VEGF-C positive groups （30. 39 ± 10. 46） than in negative groups （23. 16 ± 11.67） （P 〈0. 05）. VEGF-C semi-quantitative score was in a positive correlation with PLVD （r = 0. 334）. The positive expression rate （42.55%） and semi-quantitative score （3.68 ± 1.59） of VEGF-C increased in the lymph node positive group than in the negative group, PLVD increased in the lymph node positive group compared with that in negative group （32. 12 ± 10. 29 vs. 24. 82 ± 11.06） , P 〈 0. 05. The risk of lymphoedema increased in the VEGF-C negative group （5/14） compared with that in the positive group （3/33） （P 〈 0. 05 ）. Conclusion VEGF-C has a high rate of positive expression in breast cancer, and is positively correlated with PLVD. High expression of VEGF-C can reduce the risk of BCRL in breast cancer.