Study On The Relationship Between Lymphangiogenesis And The Expression Of VEGF-C And MMP-9 In Young And Other Aged Women With Breast Cancer

Objective: To investigate the lymphatic vessel density and the features of lymphangiogenesis. in invasive ductal carcinoma and to detect the expression of VEGF-C, MMP-9 in invasive ductal carcinoma, for analysing the association between VEGF-C, MMP-9, LVD and clinicopathological features of breast cancer. The LVD, VEGF-C, MMP-9 and clinicopathological features were investigated between young and other aged women with breast cancer.Methods:The 114 cases of invasive ductal carcinoma were selected including 51 cases under 35 years old and 63 cases over 40 years old. In addition, 20 cases of breast proliferative lesions were selected serving as control. The expression of LYVE-1, VEGF-C and MMP-9 was investigated using the immunohistochemistry methods in above two groups.Results:(1) Based on the data of 114 invasive ductal carcinoma, the median and inter-quartile range of lymphatic vessel density in experimental group was 3 and 6 respectively, both the median and inter-quartile range of lymphatic vessel density in control group were 1. Lymphatic vessel density in experimental group were obviously higher than the control group with significant difference( P >0.05). The lymphatic vessels were mainly distributed in the surrounding area of the tumor mass, and were scarcely observed in the center area of the tumor mass. No signicant difference was observed between age, tumor size, lymphatic metastasis status and the tumor grade( P >0.05).(2) The VEGF-C expression level was higher in the experimental group than in the control group( P <0.05). No signicant difference was observed between tumor size and the tumor grade( P >0.05). There's no association between VEGF-C expression level and lymphatic metastasis status( P >0.05). There wasn't any association between tumor size and the tumor grade. Significant difference was observed between low LVD group and high LVD group( P <0.05). No significant difference was seen between low MMP-9 expression group and high LVD expression group( P > 0.05).There was positive association between low LVD group and high LVD group(rs=0.417, P <0.05). There was no association between low MMP-9 expression group and high LVD expression group.(3)The MMP-9 expression level was much higher in the experimental group than in the control group ( P <0.05). The MMP-9 expression level between tumor size≤2cm group and tumor size >2cm group was obviously different with statistical significance ( P <0.05). Significant difference was found between lymphatic metastasis negative group and lymphatic metastasis positive group( P <0.05). No signicant difference was observed between age and the tumor grade( P >0.05). There was obviously positive association between MMP-9 expression level and high tumor size, lymphatic metastasis(r=0.255, 0.432. P <0.05). No association was surveyed between MMP-9 expression level and tumor grade. No signicant MMP-9 expression difference was observed between low LVD group and high LVD group( P >0.05).(4) The rate of lymphatic metastasis is higher in the young aged group than in other aged group( P <0.05), the expression of MMP-9 is higher in the young aged group than in other aged group( P <0.05). No signicant difference was observed in other items( P >0.05).Conclusion: (1) The lymphangiogenesis in invasive ductal carcinoma was in a high level, but was not associated with lymphatic metastasis, and that indicates that the lymphangiogenesis in invasive ductal carcinoma does not involved in the process of lymphatic metastasis, or make minor contribution to the lymphatic metastasis.(2) VEGF-C promotes the lymphangiogenesis in the breast cancer, and has strong association with LVD expression which indicates that VEGF-C is a important stimulating factor for lymphangiogenesis.(3)The MMP-9 expression is strongly correlated with tumor size and lymphatic metastasis . MMP-9 may play a role in the invasion and metastasis of a tumor, and has relationship with malignant biological characteristics of the tumor.(4) There are stronger invasion and higher rate of lymphatic metastasis in the young aged group than in other aged group, it suggest that the young aged group has a worse prognosis.