El-Gohary Yasser M, Metwally Ghada, Saad Reda S, Robinson Morton J, Mesko Thomas, Poppiti Robert J
The Arkadi M Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL 33410, USA.
Breast J. 2009 May-Jun;15(3):261-7. doi: 10.1111/j.1524-4741.2009.00715.x.
We investigated the significance of periductal lymphatic and blood vascular densities in intraductal carcinomas (IDC) of the breast. Thirty five cases of pure IDC treated by partial or total mastectomy were reviewed. Seven cases with normal breast tissue and 48 cases of invasive breast carcinoma were included as controls. All cases were immunostained with D2-40 and CD31. Positively stained microvessels were counted in densely vascular/lymphatic foci (hot spots) at 400x (=0.17 mm(2)) in the periductal areas. IDC without comedonecrosis showed a mean periductal D2-40 lymphatic microvessel density (LMD) of 5.8 +/- 5 (range 0-18), and a CD31 microvessel density (MD) of 14 +/- 8.9 (range 1-40). IDC with comedonecrosis showed periductal D2-40 LMD of 8.4 +/- 3.8 (range 4-18), and a CD31 MD of 24.3 +/- 7.6 (range 14-40). There was a significant difference between periductal D2-40 LMD and CD31 MD counts in IDC with and without comedonecrosis. There was a positive correlation of periductal D2-40 LMD and CD31 MD counts with high nuclear grade (r = 0.39 and 0.56) of IDC as well as with the presence of comedonecrosis (r = 0.49 and 0.59). Both D2-40 LMD and CD31 MD did not correlate significantly with tumor size, estrogen status, or progesterone status. As IDC with comedonecrosis and/or high nuclear grade has a worse prognosis than IDC without comedonecrosis and/or with low nuclear grade, it appears that lymphatic and blood vascular density evaluated by D2-40 and CD31, respectively, are independent prognostic indicators for patients with IDC of the breast and may be an indicator of early or unrecognized invasion or "regression."
我们研究了乳腺导管内癌（IDC）中导管周围淋巴管和血管密度的意义。回顾了35例接受部分或全乳切除术治疗的单纯IDC病例。纳入7例正常乳腺组织病例和48例浸润性乳腺癌病例作为对照。所有病例均用D2-40和CD31进行免疫染色。在导管周围区域400倍视野（=0.17平方毫米）的密集血管/淋巴灶（热点）中计数阳性染色的微血管。无粉刺样坏死的IDC导管周围D2-40淋巴管微血管密度（LMD）平均为5.8±5（范围0-18），CD31微血管密度（MD）为14±8.9（范围1-40）。有粉刺样坏死的IDC导管周围D2-40 LMD为8.4±3.8（范围4-18），CD31 MD为24.3±7.6（范围14-40）。有和无粉刺样坏死的IDC中，导管周围D2-40 LMD和CD31 MD计数有显著差异。导管周围D2-40 LMD和CD31 MD计数与IDC的高核分级（r = 0.39和0.56）以及粉刺样坏死的存在（r = 0.49和0.59）呈正相关。D2-40 LMD和CD31 MD均与肿瘤大小、雌激素状态或孕激素状态无显著相关性。由于有粉刺样坏死和/或高核分级的IDC比无粉刺样坏死和/或低核分级的IDC预后更差，看来分别用D2-40和CD31评估的淋巴管和血管密度是乳腺IDC患者的独立预后指标，可能是早期或未被识别的浸润或“消退”的指标。
