摘要
目的 应用免疫组织化学技术检测肿瘤微淋巴管密度（LMVD）,通过乳腺癌原发病灶彩色多普勒超声各征象与病理腋淋巴结转移及肿瘤LMVD的相关性研究,探讨乳腺癌病灶超声征象与肿瘤生物学行为及腋淋巴结转移的关系. 方法浸润性乳腺癌患者95例,年龄（50.2±12.4）岁.手术前均未进行化疗或放疗,均于术前1周内进行乳腺超声检查,观察并记录病灶大小、前后径与左右径比值（AP/W）、边缘毛刺征、病灶周围高回声晕、边界、肿瘤内及肿瘤周边血流信号分布情况以及动脉血流峰速值（PSV）、阻力指数（RJ）.随机选取30例术后肿瘤石蜡标本切片进行免疫组织化学VEGFR-3染色,计数LMVD.对病灶超声征象及血流参数与病理腋淋巴结状况及LMVD关系进行研究. 结果手术后病理结果显示,腋淋巴结转移占35.8%（34/95）,未转移占64.2%（61/95）.病灶测值最大径〉2 cm、AP/W〉1、边缘毛刺及边界模糊是发生腋淋巴结转移的危险因素（P〈0.05）,OR（95%CI）分别为5.6（2.1～14.7）、5.2（2.0～13.1）、5.5（2.0～15.2）和6.0（1.9～19.0）;彩色及能量多普勒血流征象及血流动力学参数与淋巴结转移关系的单因素分析中,病灶血流信号分级、血流分布类型及PSV〉25 cm/s与腋淋巴结转移有关（P〈0.05）;超声声像图显示病灶边界模糊组肿瘤LMVD高于边界清晰组（P〈0.05）. 结论浸润性乳腺癌病灶病灶超声征象与腋淋巴结转移相关;超声边界模糊与肿瘤LMVD相关.
[ Abstract] Objective To determine whether tumor gray scale and color Doppler sonographic characteristics predicts axillary node status in invasive breast cancer. Methods In 95 invasive cancer pa- tients, axillary lymph node metastases were found in 34 cases. Breast lesions were prospectively studied within one week before surgery. Lumpectomy or mastectomy with full axiUary nodal dissection was performed. Tumor lymphangiogenesis were immunohistochemieally assessed in a subset of 30 patients. Sono- graphic tumor size, AP/W, lesion border （spiculations, eehogenic ＂halo＂ and indistinct margin） , the num- ber of tumor blood vessels and its distribution type as well as the Doppler parameters （ PSV and RI） were correlated with axillary nodal status and tumor lymphatic mierovessel density （LMVD）. Results Tumor sonographic characteristics of indistinct border （ P 〈 0. 05 ） was significantly correlated with tumor LMVD. Invasive breast cancers sonographie features exhibited significant differences in the sonographic size （ P 〈 0. 05 ）, AP/W 〉 1 （ P 〈 0. 05 ）, speculation （ P 〈 0. 05 ）, indistinct margin （ P 〈 0. 05 ）, blood stream sig- nal in tumor （P 〈 0. 05 ）, blood vessel distributional type （P 〈 0.05 ） and peek systolic velocity （PSV） （P 〈 0.05 ） according to the pathologic axillary nodal metastases. The Odds ratios were 5.6, 5.2, 5.5, 6. 0, 2. 1, 1.8 and 3.6, respectively. Conclusion Tumor sonographic features showed significant correlation with tumor LMVD. Tumor sonographic size, AP/W, spicular border, indistinct margin, blood stream signal in tumor, blood vessel distributional type and peek systolic velocity were risk factors of axillary nodal metastases in invasive breast cancer.
出处
《中国生育健康杂志》
2010年第5期262-266,共5页
Chinese Journal of Reproductive Health
关键词
乳腺癌
腋淋巴结
超声
肿瘤微淋巴管密度
Breast carcinoma
Axillary lymph node
Ultrasonography
Lymphatic microvessel density （LMVD）
作者简介
通讯作者：李燕，E—mail：wzwlily@hotmail．com
