Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
J Surg Oncol. 2010 Sep 1;102(3):225-9. doi: 10.1002/jso.21607.
Lymph node (LN) metastasis of ductal carcinoma in situ with microinvasion (DCISM) is variable (0-14%). To ascertain the role of lymphangiogenesis in LN metastasis in DCISM, we compared the lymphatic vessel density with the presence of LN metastasis in a group of patients that underwent axillary dissection with breast surgery due to DCISM.
We identified 46 patients with a diagnosis of DCISM who underwent breast surgery with axillary dissection to evaluate LN status from June 1996 to March 2008. Microvessel density (MVD) and lymphatic vessel density (LVD) was measured by immunohistochemical staining with two markers, CD34 and D2-40.
LVD of the patients with LN metastasis was significantly higher than that of the patients without LN metastasis (P = 0.04). Correlation in the total score of progesterone receptor and LN metastasis was also noted (P = 0.017). There was no statistically significant relation between LVD and clinicopathologic parameters such as size and type of underlying DCIS, nuclear grade, presence of lymphovascular invasion, hormone receptor, and HER-2 status.
Lymphangiogenesis may be significantly associated with LN metastasis in DCISM. This is the first attempt to predict axillary LN metastasis in DCISM by quantifying the LVD.
微浸润性导管原位癌（DCISM）伴淋巴结（LN）转移的情况存在差异（0-14%）。为了确定淋巴管生成在 DCISM 中 LN 转移中的作用，我们比较了一组因 DCISM 而行乳房手术加腋窝清扫术患者的 LN 转移与淋巴管密度。
我们从 1996 年 6 月至 2008 年 3 月，共纳入 46 例因 DCISM 而行乳房手术加腋窝清扫术以评估 LN 状态的患者。通过免疫组化染色，用 CD34 和 D2-40 两种标志物测量微血管密度（MVD）和淋巴管密度（LVD）。
有 LN 转移的患者的 LVD 明显高于无 LN 转移的患者（P=0.04）。孕激素受体的总评分与 LN 转移之间也存在相关性（P=0.017）。LVD 与 DCIS 的大小和类型、核分级、是否存在脉管侵犯、激素受体和 HER-2 状态等临床病理参数之间无统计学显著关系。
淋巴管生成可能与 DCISM 中的 LN 转移显著相关。这是首次通过定量 LVD 尝试预测 DCISM 中的腋窝 LN 转移。
