乳腺癌微血管密度与临床病理特征和预后的关系

The relationship between microvessel density, clinicopathological characteristics and prognosis of primary breast cancer

目的 观察乳腺癌组织中微血管密度 (microvesseldensity ,MVD) ,分析其与临床病理特征的关系及对预后的影响。方法 采用免疫组织化学方法 (Immunohistochemistry ,IHC)检测 4 7例手术切除的乳腺癌组织中微血管密度 (MVD) ,并与临床病理特征及预后进行统计分析。结果 肿瘤组织中 2 0 0倍视野内微血管计数范围为 2 1～ 89,平均为 4 3.13± 15 .4 0 ,中位数为 4 2。淋巴结转移 >3个者微血管密度明显增高 ,与淋巴结阴性者有极显著性差异 (P <0 .0 1) ;复发转移者较无病生存者微血管密度明显增高 (P <0 .0 1) ,而与月经状况、肿瘤大小、组织分级和激素受体状况无关 (P >0 .0 5 )。Kaplan -Meier生存分析结果表明 :高MVD(>4 2 )和低MVD(≤ 4 2 )两组总生存期 (overallsurvival,OS)和无病生存期 (diseasefreesurvival,DFS)均有显著性差异 ,分别为P <0 .0 1和P <0 .0 5。Cox风险比例模型单因素分析表明 :肿瘤大小、淋巴结转移和微血管密度是影响OS和DFS的独立预后因素 (P <0 .0 5 ) ,而多因素分析则上述各种因素均无明显相关性。结论 MVD与淋巴结的转移数目、复发转移状态、无病生存和总生存相关 ,有可能成为乳腺癌另一预后预测因素。

Objective To investigate the relationship between microvessel density (MVD) , clinicphathological characteristics and the prognosis in primary breast cancer patients. Methods MVD in 47 cases of breast cancer were studied by immunohistochemistry on formalin-fixed, paraffin-embedded tumor section. Correlations between MVD, clinicphathological factors and prognosis were statistically analyzed. Results The mean of MVD was 43.13±15.40,range 21～89,median 42 in all patients. MVD was statistically significantly higher in lymph node positive (>3) or relapsed or metastatic group than in lymph node negative and disease free survival group ( P <0.01), whereas no correlations with menopausal status, tumor size, histologic grade, estrogen receptor and progesterone receptor ( P >0.05). Kaplan-Meier survival analysis indicated that both overall survival(OS) and disease free survival(DFS) statistically significantly in low-MVD and high-MVD group, P<0.01和P <0.05, respectively . Tumor size, lymph node positive number and MVD were independent prognostic factors for survival ( P <0.05) by COX regression univariate analysis. But in multivariate analysis, there were no significant differences in all factors ( P >0.05). Conclusion MVD was related with lymph node positive number, relapsed or metastatic status, DFS and OS. It could be an independent prognostic factor in breast cancer.