FACS, Department of General Surgical Science, Graduate School of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Anticancer Res. 2014 Mar;34(3):1255-9.
The prognostic value of lymphovascular invasion (LVI) in patients with breast cancer is unclear. Lymphatic invasion may mainly represent the selective affinity of breast cancer cells for lymph nodes. This study was undertaken to evaluate the presence of vascular invasion that may reflect systemic disease as a predictor of disease recurrence in breast cancer, separate from lymphatic invasion of the primary tumor.
We retrospectively evaluated the cases of 263 consecutive female patients with primary breast cancer who underwent a radical breast operation. We examined the relationship between recurrence and the prognostic significance of clinico-pathological factors, particularly lymphatic (Iy) and vascular invasion (v).
The presence of lymphatic invasion and that of vascular invasion were significant in univariate analysis. The presence of vascular invasion was an independent prognostic factor, but lymphatic invasion lost its prognostic significance in multivariate analysis. Among the 91 patients in the ly-/v- group, 5 (5.5%) had disease recurrence, and among the 73 patients in the ly+/v- group, 5 (6.8%) had disease recurrence. On the other hand, among the 95 patients in the ly+/v+ group, 19 (20.0%) had a recurrence, and among the 3 patients in the ly-/v+ group, one had a recurrence. It is interesting to note that despite the presence of lymphatic invasion, the group without vascular invasion (ly+/v-) had a few patients with distant metastases, a result which is similar to that of the ly-/v- group.
The presence of vascular invasion, but not lymphatic invasion, could be an indicator of high biological aggressiveness and may be a valid prognostic factor for breast cancer.
乳腺癌中淋巴管浸润（LVI）的预后价值尚不清楚。淋巴浸润可能主要代表乳腺癌细胞对淋巴结的选择性亲和力。本研究旨在评估血管浸润的存在，血管浸润可能反映全身性疾病，是乳腺癌复发的预测因素，与原发性肿瘤的淋巴浸润分开。
我们回顾性评估了 263 例接受根治性乳房手术的原发性乳腺癌女性患者的病例。我们检查了复发与临床病理因素（特别是淋巴（Iy）和血管浸润（v））预后意义之间的关系。
在单因素分析中，存在淋巴浸润和血管浸润具有显著意义。血管浸润的存在是独立的预后因素，但在多因素分析中，淋巴浸润失去了其预后意义。在 ly-/v-组的 91 例患者中，有 5 例（5.5%）发生疾病复发，在 ly+/v-组的 73 例患者中，有 5 例（6.8%）发生疾病复发。另一方面，在 ly+/v+组的 95 例患者中，有 19 例（20.0%）出现复发，在 ly-/v+组的 3 例患者中，有 1 例出现复发。有趣的是，尽管存在淋巴浸润，但没有血管浸润的组（ly+/v-）有少数患者发生远处转移，这一结果与 ly-/v-组相似。
血管浸润的存在，而不是淋巴浸润的存在，可能是高生物学侵袭性的指标，并且可能是乳腺癌的有效预后因素。
