Marinho Vanessa Fortes Zschaber, Metze Konradin, Sanches Fernanda Squárcio Fernandes, Rocha Gislene Fátima Silva, Gobbi Helenice
Departamento de Anatomia Patológica da Faculdade de Medicina da Universidade Federal de Minas Gerais (UFMG), BeloHorizonte, MG.
Rev Assoc Med Bras (1992). 2008 May-Jun;54(3):203-7. doi: 10.1590/s0104-42302008000300011.
The aim of our study was to analyze morphologic and molecular markers of breast cancer relating them to the presence of metastases in axillary lymph nodes.
We selected 123 cases of invasive mammary carcinomas stratified into three subgroups: with macrometastases, with micrometastases, and lymph node negative. Presence of metastases was evaluated relating them with morphologic factors (size of primary tumor, type and grade, presence of lymphatic and blood vessel invasion in hematoxylin and eosin-stained slides) and molecular factors of primary tumor (estrogen and progesterone receptors, E-cadherin, Ki67, p53, Her2 expression, and the presence of lymphatic and blood vessel invasion in immunostained sections for D2-40 and CD31).
Axillary lymph node metastases were positively related to the presence of lymphatic vessel invasion in hematoxylin and eosin (H&E)-stained slides, when analyzed with or without metastases (p=0.04) and when analyzed in the three subgroups (p=0.002). Lymph node metastases were also positively related to presence of blood vessel invasion identified by immunohistochemistry (IHC) for CD31 (p=0.02). However other morphologic and molecular factors were not related to the presence of axillary node metastases.
Lymphatic and blood vessel invasion identified in H&E and IHC-stained slides are positively related to the rmetastatic status of axillary lymph nodes and are predictive of axillary lymph node metastases in breast cancer.
本研究旨在分析乳腺癌的形态学和分子标志物，并将它们与腋窝淋巴结转移情况相关联。
我们选取了123例浸润性乳腺癌病例，分为三个亚组：有大转移灶、有微转移灶和淋巴结阴性组。通过将转移情况与形态学因素（原发肿瘤大小、类型和分级、苏木精和伊红染色切片中淋巴管和血管侵犯情况）以及原发肿瘤的分子因素（雌激素和孕激素受体、E-钙黏蛋白、Ki67、p53、Her2表达，以及D2-40和CD31免疫染色切片中淋巴管和血管侵犯情况）相关联来评估转移情况。
在分析有无转移时（p=0.04）以及在三个亚组中分析时（p=0.002），腋窝淋巴结转移与苏木精和伊红（H&E）染色切片中淋巴管侵犯的存在呈正相关。腋窝淋巴结转移也与CD31免疫组化（IHC）鉴定的血管侵犯存在呈正相关（p=0.02）。然而，其他形态学和分子因素与腋窝淋巴结转移的存在无关。
在H&E和IHC染色切片中鉴定出的淋巴管和血管侵犯与腋窝淋巴结的转移状态呈正相关，并且可预测乳腺癌腋窝淋巴结转移。
