Dhakal Hari Prasad, Bassarova Assia, Naume Bjørn, Synnestvedt Marit, Borgen Elin, Kaaresen Rolf, Schlichting Ellen, Wiedswang Gro, Giercksky Karl-Erik, Nesland Jahn M
Division of Pathology, The Norwegian Radium Hospital, Rikshospitalet University Hospital, Faculty Division The Norwegian Radium Hospital, Medical Faculty University of Oslo, Montebello, Oslo, Norway.
Histol Histopathol. 2009 Aug;24(8):1049-59. doi: 10.14670/HH-24.1049.
Manual counting of microvessels as intratumoral microvessel density (MVD) and Chalkley counting have been used in several studies to assess the prognostic impact of vascularity in invasive breast carcinomas. In our present study, the aim was to evaluate the prognostic value of angiogenesis in invasive breast carcinoma assessed by MVD and Chalkley techniques in the same series of patients. A total of 498 breast carcinoma patients with median follow up time 85 months were evaluated. The tumour vascularity was quantified by both manual microvessel count (MVD) and Chalkley count in CD34 stained breast carcinoma slides by a single investigator blinded to clinical information. Other relevant clinicopathological parameters were noted, including breast cancer related death and both loco-regional and systemic relapse. The patients were stratified by converting MVD and Chalkley counts to categorical variables to assess prognostic impact, and results were compared. High vascular grades using MVD count did not demonstrate any prognostic significance for breast cancer specific survival (BCSS) or distant disease free survival (DDFS) either in whole patient group (BCSS, p=0.517, DDFS, p=0.301) or in non-treated node negative patients (p>0.05). Chalkley count showed prognostic significance for both DDFS and BCSS in whole patient group (p<0.001) and also in untreated node negative patient group (p<0.05). In multivariate analysis, Chalkley count, but not MVD, retained the prognostic value for BCSS (p=0.007) and DDFS (p=0.014). The Chalkley count for assessing angiogenesis in invasive breast carcinomas demonstrated prognostic value. The Chalkley method appears to be the better method in estimating the prognostic impact of vascularity in invasive breast carcinomas.
在多项研究中，已采用手动计数肿瘤内微血管密度（MVD）和Chalkley计数来评估浸润性乳腺癌中血管生成对预后的影响。在我们目前的研究中，目的是在同一组患者中评估通过MVD和Chalkley技术评估的浸润性乳腺癌中血管生成的预后价值。共评估了498例中位随访时间为85个月的乳腺癌患者。由一位对临床信息不知情的研究者在CD34染色的乳腺癌玻片上通过手动微血管计数（MVD）和Chalkley计数对肿瘤血管生成进行定量。记录了其他相关的临床病理参数，包括乳腺癌相关死亡以及局部区域和全身复发情况。通过将MVD和Chalkley计数转换为分类变量对患者进行分层，以评估预后影响，并比较结果。无论是在整个患者组（乳腺癌特异性生存[BCSS]，p = 0.517；无远处疾病生存[DDFS]，p = 0.301）还是在未治疗的淋巴结阴性患者中（p>0.05），使用MVD计数的高血管分级对BCSS或DDFS均未显示出任何预后意义。Chalkley计数在整个患者组（p<0.001）以及未治疗的淋巴结阴性患者组（p<0.05）中对DDFS和BCSS均显示出预后意义。在多变量分析中，Chalkley计数而非MVD保留了对BCSS（p = 0.007）和DDFS（p = 0.014）的预后价值。Chalkley计数在评估浸润性乳腺癌的血管生成方面显示出预后价值。Chalkley方法似乎是评估浸润性乳腺癌中血管生成对预后影响的更好方法。
