Yue M, Li F, Deng H Y, Zhang L L, Liu Y P
Department of pathology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Zhonghua Zhong Liu Za Zhi. 2017 Oct 23;39(10):754-758. doi: 10.3760/cma.j.issn.0253-3766.2017.10.007.
To investigate the grading system for lymph vessel tumor emboli and its prognostic value in patients with invasive carcinomas of no special type (ICNST) of the breast. Clinical data of 466patients with ICNST were collected from January 2006 to December 2008 in the Fourth Hospital of Hebei Medical University. The expression levels of D2-40, estrogen receptor(ER), progesterone receptor(PR) and human epidermal growth factor receptor 2 (HER-2) were analyzed using immunohistochemical staining. Grades for lymph vessel tumoremboli were classified based on the number of mitotic and apoptotic figures in tumor cells under a high-power field. Correlation analysis was performed using Spearman rank correlation test. Kaplan-meier curves and Log-rank tests were used to analyze the survival rate. Multivariate Cox proportional hazard model was used to analyze the prognostic factors. Among the 466 patients, grades for lymph vessel tumor emboli were categorized as follows: 280 cases were grade 0 (60.1%); 112 cases were grade 1 (24.0%); 58 cases were grade 2 (12.5%); 16 cases were grade 3 (3.4%). Correlation analyses showed that lymph vessel tumor emboli grading system was positively correlated with lymph node metastasis (=0.365, <0.001). Kaplan-Meier univariant analysis showed that histological grading, lymph vessel tumor emboli grading system, lymph node metastasis, the expression levels of ER, PR and HER-2 and molecular typing were associated with prognosis of patients (<0.05 for all). Multivariate analysis of Cox proportional hazard model showed that lymph vessel tumor emboli grading system and lymph node metastasis were independent prognostic factors in patients with ICNST(<0.05 for all). Grading system for lymph vessel tumor emboli canpredict the clinical outcome of patients with ICNST.
探讨淋巴管肿瘤栓子分级系统及其对乳腺非特殊类型浸润性癌（ICNST）患者的预后价值。收集2006年1月至2008年12月在河北医科大学第四医院就诊的466例ICNST患者的临床资料。采用免疫组织化学染色分析D2-40、雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER-2）的表达水平。根据高倍视野下肿瘤细胞有丝分裂和凋亡图的数量对淋巴管肿瘤栓子进行分级。采用Spearman等级相关检验进行相关性分析。采用Kaplan-Meier曲线和Log-rank检验分析生存率。采用多变量Cox比例风险模型分析预后因素。466例患者中，淋巴管肿瘤栓子分级如下：0级280例（60.1%）；1级112例（24.0%）；2级58例（12.5%）；3级16例（3.4%）。相关性分析显示，淋巴管肿瘤栓子分级系统与淋巴结转移呈正相关（=0.365，<0.001）。Kaplan-Meier单因素分析显示，组织学分级、淋巴管肿瘤栓子分级系统、淋巴结转移、ER、PR和HER-2的表达水平以及分子分型与患者预后相关（均<0.05）。Cox比例风险模型多变量分析显示，淋巴管肿瘤栓子分级系统和淋巴结转移是ICNST患者的独立预后因素（均<0.05）。淋巴管肿瘤栓子分级系统可预测ICNST患者的临床结局。
