乳腺癌周围组织VEGFR-3和MLVD及乳腺癌组织SEMA4C表达与前哨淋巴结转移关系  

Relationship between VEGFR-3,microlymphatic vessel density,the expression of SEMA4C in breast cancer tissue and sentinel lymph node metastasis

作　　者：张雨露 涂剑宏 胡尔维 吴巧胜 黄爱丽 李志华 ZHANG Yu-lu;TU Jian-hong;HU Er-wei;WU Qiao-sheng;HUANG Ai-li;LI Zhi-hua(The Third Hospital of Nanchang City,Nanchang 330009,China)

机构地区：[1]南昌市第三医院乳腺外科,江西南昌330009 [2]南昌市第三医院病理科,江西南昌330009 [3]南昌市第三医院江西省乳腺疾病重点实验室,江西南昌330009

出　　处：《社区医学杂志》2022年第12期662-668,共7页Journal Of Community Medicine

基　　金：江西省卫生计生委科技计划(20187044)

摘　　要：目的探讨乳腺癌周围组织中血管内皮生长因子受体-3(VEGFR-3)、微淋巴管密度(MLVD)及乳腺癌组织中人臂板蛋白4C(SEMA4C)表达对前哨淋巴结转移的预测价值。方法收集2018-10-01-2019-12-31南昌市第三医院初治诊断为乳腺浸润性癌且行全乳切除+前哨淋巴结活体组织检查的213例患者组织标本。采用免疫组化法检测213例乳腺癌周组织(乳腺癌病灶周围约0.5 cm处的乳腺组织)中VEGFR-3、MLVD及乳腺癌组织中SEMA4C蛋白的表达,χ^(2)及t检验分析其与前哨淋巴结转移的关系,Logistic回归分析前哨淋巴结转移的预测因素。结果前哨淋巴结转移组中,癌周组织中VEGFR-3的表达率为87.8%,高于前哨淋巴结阴性组的28.2%,χ^(2)=71.602,P<0.001;癌组织中VEGFR-3的表达率为53.7%,高于前哨淋巴结阴性组的29.0%,χ^(2)=12.943,P<0.001。癌周组织MLVD为(11.68±3.82)/100倍视野,高于前哨淋巴结阴性组的(4.15±3.43)/100倍视野,t=14.931,P<0.001;癌组织中MLVD为(4.67±2.22)/100倍视野,高于前哨淋巴结阴性组的(1.44±2.19)/100倍视野,t=10.424,P<0.001。癌组织中SEMA4C的表达率为73.2%,高于前哨淋巴结阴性组的6.9%,χ^(2)=101.225,P<0.001。多因素Logistic回归分析发现,癌周组织中VEGFR-3(P=0.023)、癌组织中SEMA4C(P=0.001)和癌周组织中MLVD(P<0.001)是前哨淋巴结转移的独立预测指标。结论在临床中,检测癌周组织中VEGFR-3、MLVD及癌组织中SEMA4C可作为判断前哨淋巴结转移的依据。Objective To investigate the relationship between the expression of vascular endothelial growth factor receptor-3(VEGFR-3),microlymphatic vessel density(MLVD)and SEMA4 C protein in breast cancer tissues and clinical value of predicting metastasis in sentinel lymph node carcinoma.Methods All tissues were obtained from patients with invasive breast cancer who were undergone total mastectomy+sentinel lymph node biopsy and were initially diagnosed in Third Hospital of Nanchang City from October 1,2018 to December 31,2019.Immunohistochemistry was used to detect VEGFR-3,MLVD and SEMA4 C protein in 213 breast cancer tissues.Their relationship with sentinel lymph node metastasis was analyzed byχ^(2)test and t test,and the predictive factors of sentinel lymph node metastasis were analyzed by logistic regression.Results In the sentinel lymph node metastasis group,the expression rate of peritumoral VEGFR-3 was 87.8%,which was higher than that in the sentinel negative group(28.2%),χ^(2)=71.602,P<0.001.The expression rate of VEGFR-3 in cancer was 53.7%,which was higher than 29.0%in sentinel negative group,χ^(2)=12.943,P<0.001.Peritumoral MLVD was(11.68±3.82)/100 magnification field,higher than that of sentinel negative group(4.15±3.43)/100 magnification field,t=14.931,P<0.001.MLVD in cancer was(4.67±2.22)/100 magnification field,higher than that of sentinel negative group(1.44±2.19)/100 magnification field,t=10.424,P<0.001.The expression rate of SEMA4 C in cancer was 73.2%,which was higher than 6.9%in sentinel negative group,χ^(2)=101.225,P<0.001.Multivariate logistic regression analysis showed that VEGFR-3(P=0.023),SEMA4C(P=0.001)and MLVD(P<0.001)were independent predictors of sentinel lymph node metastasis.Conclusion In clinical practice,the detection of VEGFR-3,MLVD and SEMA4Cin cancer can be used as the basis for judging sentinel lymph node metastasis.

关 键 词：乳腺癌 癌周组织 血管内皮生长因子受体-3 人臂板蛋白4C 微淋巴管密度 前哨淋巴结转移 

分 类 号：R737.9[医药卫生—肿瘤]