原发性可手术浸润性导管乳腺癌患者的淋巴管浸润与血管生成、激素受体、细胞增殖及生存之间的关系。
The relationship between lymphovascular invasion and angiogenesis, hormone receptors, cell proliferation and survival in patients with primary operable invasive ductal breast cancer.
作者信息
Mohammed Zahra Ma, McMillan Donald C, Edwards Joanne, Mallon Elizabeth, Doughty Julie C, Orange Clare, Going James J
机构信息
Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences, Royal Infirmary, University of Glasgow, Glasgow G31 2ER, UK.
University Departments of Pathology, Faculty of Veterinary Medicine, Omar Almukhtar University, Al bayda, PO Box 919, Libya.
出版信息
BMC Clin Pathol. 2013 Nov 25;13(1):31. doi: 10.1186/1472-6890-13-31.
BACKGROUND
Several well-established tumour prognostic factors are used to guide the clinical management of patients with breast cancer. Lymphovascular invasion and angiogenesis have also been reported to have some promise as prognostic factors. The aim of the present study was to examine the prognostic value of tumour lymphovascular invasion and microvessel density compared with that of established prognostic factors in invasive ductal breast cancer.
METHODS
In addition to hormone receptor status and Ki-67 proliferative activity, lymphovascular invasion and microvessel density and their relationship with survival were examined in patients with invasive ductal breast cancer. Full sections and tissue microarrays (n = 384 patients) were utilised to assess these factors and were scored by appropriate methods.
RESULTS
On univariate analysis tumour size (P < 0.05), lymph node involvement (P < 0.01), lymphovascular invasion (P < 0.05), microvessel density (P < 0.05) and local- regional treatment (P < 0.01) were associated with poorer survival in ER negative tumours. On multivariate analysis in ER negative tumours lymph node involvement (P < 0.01) and local- regional treatment (P < 0.05) were independently associated with poorer cancer-specific survival. On univariate analysis tumour grade (P < 0.05), lymph node involvement (P < 0.001), HER-2 (P < 0.05), Ki-67 (P < 0.01) and lymphovascular invasion (P < 0.001) were associated with poorer survival in ER positive tumours. On multivariate analysis lymph node involvement (P < 0.001), Ki-67 (P < 0.001) and lymphovascular invasion (P < 0.05) were independently associated with poorer cancer-specific survival in ER positive tumours.
CONCLUSION
Lymphovascular invasion but not microvessel density was independently associated with poorer survival in patients with ER positive but not ER negative invasive ductal breast cancer.
背景
几种已确立的肿瘤预后因素用于指导乳腺癌患者的临床管理。据报道，淋巴管浸润和血管生成作为预后因素也具有一定前景。本研究的目的是在浸润性导管癌中，将肿瘤淋巴管浸润和微血管密度的预后价值与已确立的预后因素进行比较。
方法
除了激素受体状态和Ki-67增殖活性外，还对浸润性导管癌患者的淋巴管浸润、微血管密度及其与生存的关系进行了研究。利用全切片和组织微阵列（n = 384例患者）评估这些因素，并采用适当方法进行评分。
结果
单因素分析显示，肿瘤大小（P < 0.05）、淋巴结受累（P < 0.01）、淋巴管浸润（P < 0.05）、微血管密度（P < 0.05）和局部区域治疗（P < 0.01）与雌激素受体（ER）阴性肿瘤患者较差的生存率相关。多因素分析显示，在ER阴性肿瘤中，淋巴结受累（P < 0.01）和局部区域治疗（P < 0.05）与较差的癌症特异性生存率独立相关。单因素分析显示，肿瘤分级（P < 0.05）、淋巴结受累（P < 0.001）、人表皮生长因子受体2（HER-2）（P < 0.05）、Ki-67（P < 0.01）和淋巴管浸润（P < 0.001）与ER阳性肿瘤患者较差的生存率相关。多因素分析显示，在ER阳性肿瘤中，淋巴结受累（P < 0.001）、Ki-67（P < 0.001）和淋巴管浸润（P < 0.05）与较差的癌症特异性生存率独立相关。
结论
在ER阳性而非ER阴性的浸润性导管癌患者中，淋巴管浸润而非微血管密度与较差的生存率独立相关。
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