Greenberg Ron, Schwartz Ignat, Skornick Yehuda, Kaplan Ofer
Department of Surgery A, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
Breast Cancer Res. 2003;5(3):R71-6. doi: 10.1186/bcr588. Epub 2003 Mar 6.
The diverse biological effects of hepatocyte growth factor/scatter factor (HGF/SF) are mediated by c-Met, which is preferentially expressed on epithelial cells. Met signaling has a role in normal cellular activities, and may be associated with the development and progression of malignant processes. In this study we examined whether Met can be detected in the axillary drainage from patients who underwent conservative operations for breast cancer, and its prognostic significance.
Thirty-one consecutive patients with invasive ductal carcinoma of the breast suitable for breast-conserving treatment were studied. The output of the drain that had been placed in the axilla during the operation was collected, and the presence of Met and beta-actin were assessed by reverse transcriptase-polymerase chain reaction (RT-PCR) assays. The data were compared with the pathological features of the tumor and the axillary lymph nodes, and with the estrogen receptor and progesterone receptor status.
RT-PCR of the axillary lymphatic drainage was positive for Met in 23 (74.2%) of the patients. Positive assays were correlated with increasing tumor size and grade, with capillary and lymphatic invasion, and with lymph node metastasis (P < 0.02, for all comparisons). All 12 patients with axillary lymph node metastases had positive assays for Met, compared with 57.9% of patients without lymph node metastases. All five patients with tumor involvement in the margins of the resection had positive assays for Met in their lymphatic fluid, compared with 18 of 26 positive assays (69.2%) for patients without involved margins (P < 0.04). Finally, Met showed negative correlations with positivity for estrogen receptor and progesterone receptor (P < 0.02).
Met can be detected in the axillary fluids of patients with breast cancer and its expression in the axillary drainage may have potential as a prognostic factor. This finding might be relevant to therapeutic considerations, because a positive assay for Met in histologically node-negative patients might point to the need to search for node microinvasion or involvement of the excision margins with tumor.
肝细胞生长因子/分散因子（HGF/SF）的多种生物学效应由c-Met介导，c-Met在上皮细胞中优先表达。Met信号传导在正常细胞活动中起作用，并且可能与恶性肿瘤的发生和发展有关。在本研究中，我们检测了接受乳腺癌保乳手术患者的腋窝引流液中是否能检测到Met及其预后意义。
对31例适合保乳治疗的浸润性导管癌患者进行研究。收集手术期间置于腋窝的引流管的引流液，通过逆转录聚合酶链反应（RT-PCR）检测Met和β-肌动蛋白的存在。将数据与肿瘤和腋窝淋巴结的病理特征以及雌激素受体和孕激素受体状态进行比较。
23例（74.2%）患者腋窝淋巴引流液的RT-PCR检测Met呈阳性。阳性检测结果与肿瘤大小增加、分级增加、毛细血管和淋巴管浸润以及淋巴结转移相关（所有比较P<0.02）。所有12例腋窝淋巴结转移患者的检测结果均为Met阳性，而无淋巴结转移患者的这一比例为57.9%。所有5例肿瘤累及切除边缘的患者其淋巴液中Met检测均为阳性，而26例边缘未受累患者中有18例（69.2%）检测为阳性（P<0.04）。最后，Met与雌激素受体和孕激素受体阳性呈负相关（P<0.02）。
乳腺癌患者的腋窝液中可检测到Met，其在腋窝引流液中的表达可能具有作为预后因素的潜力。这一发现可能与治疗考虑相关，因为组织学上淋巴结阴性患者Met检测呈阳性可能表明需要寻找淋巴结微浸润或肿瘤累及切除边缘的情况。
