Kanjanapanjapol Siroj, Wongwaisayawan Sansanee, Phuwapraisirisan Samart, Wilasrusmee Chumpon
Department of Surgery, Ramathibodi Hospital, Bangkok 10400, Thailand.
J Med Assoc Thai. 2007 Feb;90(2):282-90.
Angiogenesis is important in the process of tumor growth and progression of breast cancer Microvessel density (MVD) is the most commonly used technique to quantify intratumoral angiogenesis in breast cancer. In the present study, the authors investigated the prognostic indicator of intratumoral MVD in predicting overall survival, disease recurrence, and distance metastasis of breast cancer.
Two hundred patients who were diagnosed as invasive breast cancer from January 2000 to December 2004 were included in the present study, but only 64 patients had complete pathological specimens and tumor receptor studies. Representative paraffin sections of the primary tumor including the tumor border were immunostained with a monoclonal anti-CD34 antibody. The area of highest vascular density ("hot spot") was identified and the average count of three hot spots in each tumor was used for analyses. The distribution of MVD was categorized into high and low MVD as more than 76 and less than 76 respectively. Overall survival probability was estimated by the Kaplan-Meier method. A multivariate Cox regression was employed to examine the relationship between MVD and disease outcomes while adjusting for other concomitant variables.
The tumor size and more advanced disease have correlated with poor outcomes of invasive breast cancer. Tumor size is a poor predictor for local recurrence [Harzard ratio 1.02 (95% CI 0.99-1.04)] and more disease staging have correlated with distance metastases [Harzard ratio 1.48 (95% CI 0.98-2.24)]. The cancer staging only predicted poor outcome in invasive breast cancer in overall recurrence [Harzard ratio 1.51 (95% CI 1.05-2.16)]. MVD is not correlated with both tumor recurrence and distance metastases [Hazard ratio for local recurrence 1.01 (95% CI 0.99-1.04) and Harzard ratio 1.00 (95% CI 0.97-1.02)].
The microvessel density (MVD) has not predicted poor outcomes of invasive breast cancer in Thai woman.
血管生成在乳腺癌的肿瘤生长和进展过程中起着重要作用。微血管密度（MVD）是量化乳腺癌肿瘤内血管生成最常用的技术。在本研究中，作者调查了肿瘤内MVD在预测乳腺癌总生存期、疾病复发和远处转移方面的预后指标。
本研究纳入了2000年1月至2004年12月期间被诊断为浸润性乳腺癌的200例患者，但只有64例患者有完整的病理标本和肿瘤受体研究。用单克隆抗CD34抗体对包括肿瘤边界在内的原发性肿瘤代表性石蜡切片进行免疫染色。确定血管密度最高的区域（“热点”），并将每个肿瘤中三个热点的平均计数用于分析。MVD分布分为高MVD和低MVD，分别为大于76和小于76。采用Kaplan-Meier法估计总生存概率。采用多变量Cox回归分析MVD与疾病结局之间的关系，同时对其他伴随变量进行校正。
肿瘤大小和疾病进展程度与浸润性乳腺癌的不良结局相关。肿瘤大小对局部复发的预测能力较差[风险比1.02（95%可信区间0.99-1.04）]，疾病分期越高与远处转移相关[风险比1.48（95%可信区间0.98-2.24）]。癌症分期仅在总体复发中预测浸润性乳腺癌的不良结局[风险比1.51（95%可信区间1.05-2.16）]。MVD与肿瘤复发和远处转移均无相关性[局部复发风险比1.01（95%可信区间0.99-1.04），远处转移风险比1.00（95%可信区间0.97-1.02）]。
微血管密度（MVD）不能预测泰国女性浸润性乳腺癌的不良结局。
