Li Ying-jia, Wen Ge, Yang Li
Department of Ultrasound Diagnosis, Nanfang Hospital, Nanfang Medical University, Guangzhou 510515, China.
Zhonghua Yi Xue Za Zhi. 2009 Mar 10;89(9):587-91.
To study the effects of angiogenesis on tumorigenesis and the progression of breast carcinoma and precancerous lesion.
Real time ultrasound contrast enhanced microvascular imaging (MVI) and time-intensity curve quantitative analysis were conducted on 30 normal controls, 30 cases with simple hyperplasia, 30 cases with atypical hyperplasia (AH), 20 cases with intraductal carcinoma in situ, and 50 cases with invasive ductal carcinoma, all female. Specimens of breast tissues were obtained and immunohistochemistry was used to detect the expression of CD34, a marker of vascular endothelial cells, and vascular endothelial growth factor (VEGF) and its receptor Flk-1/KDR.
With the progression of malignant transformation of breast tissue, the expression levels of VEGF and Flk-1/KDR increased gradually, the framework of the vessels became disordered, the levels of MVD and the perfusion parameters, such as peak intensity (PI), area under the curve (AUC), and wash-out time (WOT), increased. Obvious changes in these parameters began since the AH stage. There were not significant differences in the PI, AUC, and WOT levels between the groups of AH and in situ cancer, however, the VEGF and Flk-1/KDR levels of the in situ carcinoma group were significantly higher than those of the AH group (both P<0.05).
Angiogenesis plays an important role in the development of breast carcinoma. Contrast MVI and the main perfusion parameters reflect the rule of angiogenesis activity changing in different precancerous lesions, and can be used as non-invasive methods to screen high risk population.
研究血管生成对乳腺癌及癌前病变的发生发展的影响。
对30例正常对照者、30例单纯性增生患者、30例非典型增生(AH)患者、20例导管原位癌患者及50例浸润性导管癌患者(均为女性)进行实时超声造影微血管成像(MVI)及时间-强度曲线定量分析。获取乳腺组织标本,采用免疫组织化学法检测血管内皮细胞标志物CD34、血管内皮生长因子(VEGF)及其受体Flk-1/KDR的表达。
随着乳腺组织恶变程度的进展,VEGF及Flk-1/KDR表达水平逐渐升高,血管结构紊乱,微血管密度(MVD)及灌注参数如峰值强度(PI)、曲线下面积(AUC)、洗脱时间(WOT)升高。这些参数自AH期开始出现明显变化。AH组与原位癌组之间PI、AUC及WOT水平差异无统计学意义,但原位癌组VEGF及Flk-1/KDR水平显著高于AH组(均P<0.05)。
血管生成在乳腺癌的发生发展中起重要作用。超声造影MVI及主要灌注参数反映了不同癌前病变中血管生成活性变化规律,可作为筛查高危人群的无创方法。