Department of Pathology, Bergonié Institute, Regional Cancer Center, Bordeaux Cedex, France.
Cancer. 2010 Jul 1;116(13):3093-101. doi: 10.1002/cncr.25137.
Lymphovascular invasion (LVI) is a widely recognized prognostic factor in lymph node-negative breast cancers. However, there are only limited and controversial data about its prognostic significance in lymph node-positive patients.
Among 931 patients operated on and monitored at the authors' institution for an invasive breast carcinoma between 1989 and 1992, all 374 lymph node-positive breast cancers entered the study (median follow-up, 126 months).
LVI was present in 46% of tumors and was associated with age < or = 40 years (P = .02), high histological grade (P = .01), and negative estrogen receptor status (P = .032), but not with tumor size, number of involved lymph nodes, or HER-2/neu status. LVI was an independent prognostic factor for distant metastases (P = .002). Furthermore, in HER-2/neu-negative/hormone receptor-positive (n = 287) tumors, the number of independent prognostic factors (LVI, age, histological grade, number of involved lymph nodes, and tumor size) was associated with a 5-years metastasis-free survival ranging from 100% if no factors (n = 25) to 89% +/- 2% if 1 or 2 factors (n = 186) and 67% +/- 6 if 3, 4, or 5 factors (n = 76) were present (P < .001).
LVI is an independent prognostic factor in lymph node-positive breast cancer and merits further prospective investigations as a decision tool in the adjuvant chemotherapy setting.
淋巴管浸润（LVI）是淋巴结阴性乳腺癌的一个广泛认可的预后因素。然而，关于其在淋巴结阳性患者中的预后意义，仅有有限且有争议的数据。
在作者机构于 1989 年至 1992 年间对浸润性乳腺癌进行手术和监测的 931 例患者中，所有 374 例淋巴结阳性乳腺癌均进入研究（中位随访时间 126 个月）。
LVI 存在于 46%的肿瘤中，与年龄≤40 岁（P=0.02）、高组织学分级（P=0.01）和阴性雌激素受体状态（P=0.032）相关，但与肿瘤大小、受累淋巴结数量或 HER-2/neu 状态无关。LVI 是远处转移的独立预后因素（P=0.002）。此外，在 HER-2/neu 阴性/激素受体阳性（n=287）肿瘤中，独立预后因素（LVI、年龄、组织学分级、受累淋巴结数量和肿瘤大小）的数量与 5 年无转移生存率相关，如果没有因素（n=25）则为 100%，如果有 1 或 2 个因素（n=186）则为 89%±2%，如果有 3、4 或 5 个因素（n=76）则为 67%±6%（P<0.001）。
LVI 是淋巴结阳性乳腺癌的独立预后因素，值得进一步前瞻性研究，作为辅助化疗中决策工具。
