Agarwal Sonal, Singh Amarjit, Bagga Permeet Kaur
Department of Pathology, Government Medical College, Amritsar, Punjab, India.
Indian J Pathol Microbiol. 2018 Jan-Mar;61(1):39-44. doi: 10.4103/IJPM.IJPM_791_16.
Carcinoma breast is ever-evolving and becoming increasingly prevalent in India. Numerous prognostic factors based on morphology and immunohistochemistry (IHC) have been established which need to be interconnected to give patients best possible treatment.
This study aims to confirm and analyze lymphovascular invasion (LVI) detected by hematoxylin and eosin (H and E) using IHC with CD34 and D2-40 and its correlation with other biologic and morphologic prognostic markers.
This was a prospective study.
Fifty mastectomy specimens diagnosed as infiltrating ductal carcinoma breast on histopathology selected for the study. Evaluation of formalin-fixed paraffin-embedded sections was done using H and E and IHC for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 HER2/neu receptors, CD34, and D2-40 endothelial markers. Correlation of LVI done with prognostic markers of Carcinoma Breast, namely, age of the patient, tumor size, Nottingham grade, lymph node ratio (LNR), Nottingham prognostic index (NPI), ER/PR status, and HER2/neu status. CD34 and D2-40 utilized to distinguish blood vessel, lymph vessel, and retraction artifacts and to calculate lymphatic microvessel density (LMVD) and blood microvessel density (BMVD).
SPSS Software Package.
LVI was associated with younger age (P = 0.001), greater tumor size (P = 0.007), higher Nottingham grade (P = 0.001), higher LNR (P = 0.001), higher NPI (P = 0.001), Negative ER Status (P = 0.001), Negative PR Status (P = 0.002), Positive HER2/neu status (P = 0.021), Higher Intratumoral BMVD (P = 0.016), Peritumoral BMVD (P = 0.001), and Intratumoral LMVD (P = 0.009). Blood vessels more commonly invaded than lymph vessels. Retraction artifacts can be mistaken for LVI without IHC.
D2-40 is a promising marker for lymphatic endothelium. LVI is a poor prognostic marker hence should be evaluated imperatively in all cases of carcinoma breast.
乳腺癌在印度不断演变且日益普遍。基于形态学和免疫组织化学（IHC）已建立了许多预后因素，需要将它们相互联系起来，以便为患者提供最佳治疗。
本研究旨在通过使用CD34和D2-40免疫组织化学方法确认和分析苏木精和伊红（H&E）染色检测到的淋巴管侵犯（LVI）及其与其他生物学和形态学预后标志物的相关性。
这是一项前瞻性研究。
选取50例经组织病理学诊断为浸润性导管癌的乳房切除标本进行研究。对福尔马林固定石蜡包埋切片进行H&E染色以及雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2/neu）受体、CD34和D2-40内皮标志物的免疫组织化学评估。将LVI与乳腺癌的预后标志物进行相关性分析，这些标志物包括患者年龄、肿瘤大小、诺丁汉分级、淋巴结比率（LNR）、诺丁汉预后指数（NPI）、ER/PR状态和HER2/neu状态。利用CD34和D2-40区分血管、淋巴管和收缩伪像，并计算淋巴管微血管密度（LMVD）和血管微血管密度（BMVD）。
SPSS软件包。
LVI与较年轻的年龄（P = 0.001）、更大的肿瘤大小（P = 0.007）、更高的诺丁汉分级（P = 0.001）、更高的LNR（P = 0.001）、更高的NPI（P = 0.001）、ER阴性状态（P = 0.001）、PR阴性状态（P = 0.002）、HER2/neu阳性状态（P = 0.021）、肿瘤内更高的BMVD（P = 0.016）、肿瘤周围BMVD（P = 0.001）和肿瘤内LMVD（P = 0.009）相关。血管比淋巴管更常受到侵犯。若无免疫组织化学检查，收缩伪像可能被误认为LVI。
D2-40是一种有前景的淋巴管内皮标志物。LVI是一个不良预后标志物，因此在所有乳腺癌病例中都应进行评估。
