| (Abstract]Objective: To determine the absolute and relative value of microvessel density (MVD), vascular endothelium growth fctor (VEGF) protein and nm23 gene expression in primary tumor in predicting outcome of axillary lymph-node negative breast carcinoma. Patients and Methods: We monitored 40 patients with ANNBC for a median of 65 months. Intratumoral MVD was measured after microovessels were immunostained using anti-CD34 antibody. VEGF protein and nm23 gene expression were also determined immunohistochemically. Results were analyzed by t test, Chi-Square test, univariate and multivariate statistical analysis. Results: No correlations of MVD and VEGF expression were noted with age, tumor size, menstrual status and estrogen receptor status (P>0.05). nm23 gene expression was positively correlated with menstrual status and estrogen receptor status (P<0.05), but not with age, tumor size, MVD and VEGF expression (P>0.05). MVD, VEGF and nm23 expression were positively correlated with distant metastasis (P<0.05). Univariate analysis by Kaplan-Mierer survival analysis showed that MVD, VEGF and nm23 expression were significantly predictive of DFS (P0.0068, 0.00 19, 0.0009, respectively), but only MVD and VEGF were predictive of OS (P0.0145, 0.0167, respectively). Combination of MVD and nm23 expression was significantly predictive of both DFS (P=0.0001) and OS (P=0.005 1). In high MVD group, chemotherapy and hormonal therapy were not relatede with distant metatasis and death. Multivariate analysis4showed that MVD (P0.OO 12) and nm23 expression (P=O.0023) were both significant and independent prognostic factors for DFS.Conclusion:MVD, VEGF and nm23 expression are all prognostic indicators for distant metastasis, and MVD and nm23 expression are independent prognostic indicators for distant metastasis. Combination of MVD and nm23 was more useful in predicting distant metastasis. High MVD may be a predictor for chemotherapy and hormonal therapy resistance. These indictors are useful in selection of high-risk ANNBC patients who may be eligible to receive appropriate adjuvant therapy, such as anti-angiogenesis therapy, gene therapy. |
