乳腺癌淋巴管生成与前哨淋巴结状态的关系  

Relationship between tumor lymphangiogenesis and metastasis of sentinel lymph nodes in breast cancer patients

作　　者：赵迎春 李勇 朱永云 罗传瑜 

机构地区：[1]芜湖市第二人民医院乳腺外科,241000 [2]芜湖市第二人民医院病理科,241000

出　　处：《临床与实验病理学杂志》2013年第9期949-952,共4页Chinese Journal of Clinical and Experimental Pathology

基　　金：安徽省卫生厅自然科学基金(09C230)

摘　　要：目的探讨乳腺癌淋巴管生成密度与前哨淋巴结转移状态的关系。方法采用免疫组化SP法对68例行前哨淋巴结活检的乳腺癌标本进行染色,用D2-40、CD34分别标记淋巴管和微血管后进行密度计数,对前哨淋巴结转移状态与临床病理参数的关系进行统计学分析。结果前哨淋巴结阳性组患者的肿瘤周围淋巴管密度(peri-lymphatic vessel density,P-LVD)明显高于阴性组,前哨淋巴结状态、淋巴管密度(lymphatic vessel density,LVD)、微血管密度(microvessel density,MVD)与患者的年龄、肿块大小、组织学分级、淋巴管浸润、ER、PR及HER-2的表达等临床病理参数无关。多因素分析提示P-LVD是前哨淋巴结转移的独立危险因素。结论乳腺癌周围淋巴管生成与前哨淋巴结的转移密切相关,通过定量分析肿瘤P-LVD可为前哨淋巴结评估提供依据。Purpose To compare the lymphatic vessel density with the presence of sentinel lymph node （SLN） metastasis in a group of patients that underwent axillary dissection with breast surgery. Methods To identified 68 patients with breast cancer who underwent breast surgery with sentinel lymph node biopsy and axillary dissection to evaluate SLN status from 2009 to 2012. Microvessel density （MVD） and lymphatic vessel density （LVD） was measured by immunohistochemical staining with two markers, CD34 and D2-40. Re- suits LVD of the patients with SLN metastasis was significantly higher than that of the patients without SLN metastasis （ P = 0.01 ）. There was no statistically significant relation between the status of SLN, LVD, MVD and clinieopathologic parameters such as age, size and type of tumor, tumor grade, presence of lymphovaseular invasion, hormone receptor, and HER-2 status. Multivariate risk analysis revealed that the lymphatic density （LVD） of primary tumor, an index of tumor lymphangiogenesis, was the most sensitive predictive marker for sentinel lymph node metastasis. Conclusions Lymphangiogenesis may be significantly associated with SLN metastasis in breast cancer. This is the first attempt to provide the tool for predicting axillary SLN metastasis by quantifying the LVD.

关 键 词：乳腺肿瘤 前哨淋巴结状态 淋巴管生成 

分 类 号：R737.9[医药卫生—肿瘤]