高密度肿瘤相关中性粒细胞浸润与血管生成拟态是乳腺癌预后不良的危险因素

High-density tumor-associated neutrophils infiltration and vasculogenic mimicry as risk factors for poor prognosis in breast cancer

目的观察乳腺癌组织中肿瘤相关中性粒细胞(tumor-associated neutrophils,TANs)的浸润和血管生成拟态(vasculogenic mimicry,VM)现象,探讨其相互关系及临床病理意义。方法收集224例行根治切除术的乳腺非特殊型浸润性癌患者的临床病理资料,采用CD34免疫组织化学/高碘酸-雪夫双重染色检测VM的形成,CD66b免疫组织化学标记TANs,分析两者的关系及其与乳腺癌临床病理特征的关系。结果在60名(26.8%)患者中观察到VM现象。VM与乳腺癌组织学分级、肿瘤大小、TNM分期及HER-2过表达呈正相关,与ER和PR表达呈负相关。乳腺癌组织中性粒细胞浸润密度为0~29.0/HFP,中位数为1.2/HFP。TANs浸润密度与组织学分级和Ki-67指数呈正相关,与ER和PR表达呈负相关。VM与高密度TANs呈正相关。VM和高密度TANs与无进展生存(progression-free survival,PFS)呈负相关。多因素分析显示VM是较差的PFS独立危险因素。结论乳腺癌组织中VM现象和高密度TANs浸润关系密切,可作为预测乳腺癌进展和预后的潜在指标。

Objective To observe the infiltration of tumor-associated neutrophils(TANs)and the phenomenon of vasculogenic mimicry(VM)in breast cancer tissues,and to explore their interrelationship and clinical pathological significance.Methods Clinical pathological data from 224 patients with non-special type invasive breast cancer who underwent radical mastectomy were collected.CD34 immunohistochemistry/Periodic acid-Schiff double staining was used to detect the formation of VM,and CD66b immunohis-tochemistry was used to mark TANs,analyzing their relationship and their relationship with the clinical pathological characteristics of breast cancer.Results The VM phenomenon was observed in 60 patients(26.8%).VM was positively correlated with histological grade of breast cancer,tumor size,TNM stage,and HER-2 overexpression,and negatively correlated with ER and PR expression.The infiltration density of TANs in breast cancer tissues ranged from 0 to 29.0/HFP,with a median of 1.2/HFP.The infiltration density of TANs was positively correlated with histological grade and Ki-67 index,and negatively correlated with ER and PR expression.VM was positively correlated with high-density infiltration of TANs.VM and high-density infiltration of TANs were negatively correlated with progression-free survival(PFS).Multivariate analysis showed that VM was an independent risk factor for poor PFS.Conclusion The phenomenon of VM and high-density infiltration of TANs in breast cancer tissues are closely related and can serve as potential indicators for predicting the progression and prognosis of breast cancer.