Expression Of VEGF-C And VEGF-D In Breast Carcinoma And Its Relationship With LMVD And Lymphatic Node Metastases

Objective: The main metastasis approach of breast cancer is fromlymphatic system. The lymphatic node metastasis is also the important factorwith important influence in surgery patient′s prognosis and patient surial. So itis become the important and urgent problem to research the breast cancerlymphatic system and how to reduce breast cancer lymph node metastasis toimprove breast cancer surial of patients. Vascular endothelial growth factor-C、D from vascular endothelial growth factor having another name of vascularpermeability factor closely related to tumor lymphangiogenesis and lymphaticnode metastasis. The lymphatic vessels is an important way of transferingtumor cells to regional lymphatic nodes. At present clinicopathological study ofVEGF-C and D expression with lymphatic node metastasis is clear though thereare many reports, but the research relations between VEGF-C、 D expression,lymphatic vessel density (LVD) and lymphatic node metastasis are still lessclear. In this study of VEGF-C、D and lymphatic vessel density of breast cancertissue and lymphatic node detection, we are to explore the relationship betweenthem. Methods: The79patients of breast invasive ductal carcinoma surgicalresection specimens were obtained randomly in Mammary Surgery of LuzhouMedical College Hospital from October2009to October2011.The breast invasive ductal carcinoma whose cutting edge with non-cancerous tissues wereparaffin-embedded with pathologically confirmed. Cases all are from womenaged from30to77years old, median age of52years, an average of53±3.6years old. There is no case been treated by preoperative chemotherapy,radiation therapy,and all cases had adopted a modified radical mastectomy,intraoperativing I, II axillary lymphatic nodes, all specimens had completeclinical and pathological datas. Staining by the streptavidin-biotin peroxidase(SP),the optical microscope observation from the tissue around tumor, thecentral breast tumor tissue and normal breast was made for searching VEGF-C、D protein expression and micro-lymphatic marked by D2.40. we analysed theexpression of vascular endothelial growth factor-C、 D in breast cancer andmicro-lymphatic on the edge and normal breast tissue,combined with the resultsof pathological examination of axillary lymphatic node metastasis to explorethe relationship between their mutual relationship and pathobiological factors.Results:1.VEGF-C was expressed in the cytoplasm of breast cancer cells.The62cases(78.48%) showed VEGF-C positive expression from79cases of breastcancer. The52cases(91.07%) showed VEGF-C positive expression from56cases with lymphatic node metastasis specimens. The11cases(47.83%) showedVEGF-C positive expression from23cases with no lymphatic node metastasisspecimens. Lymphatic microvessel density (LMVD) has significant differencesbetween the different levels expression of VEGF-C group. Eachgroup(VEGF-C：-group，+group，++group，+++group) compared with pairwise analysis (LSD method): among every group P<0.05. Positivecorrelation between VEGF-C and LMVD(r=0.721,P<0.01).2,The60cases(75.95%) showed VEGF-D positive expression from79cases of breastcancer. The51cases(89.27%) showed VEGF-D positive expression from56cases with lymphatic node metastasis specimens. The9cases(43.48%) showedVEGF-D positive expression from23cases with no lymphatic node metastasisspecimens. Lymphatic microvessel density (LMVD) has significant differencesbetween the different levels expression of VEGF-D group. Each group(VEGF-D：-group，+group，++group，+++group，++++group) comparedwith pairwise analysis (LSD method): among every group P<0.05. Positivecorrelation between VEGF-D and LMVD（r=0.828, P<0.01）.3.The lymphaticdensity of around breast cancer tissue had expansion of irregular shape mostlywas more than the centre and normal breast issue. there was68cases(86.08%)of positive rate from79cases of breast cancer stained by D2.40. The LMVDaround breast cancer was from0to12.4strips averaging5.11±2.83strips. Inthe central area the LMVD was from0to3.2strips averaging1.34±0.85strips.The LMVD of normal mammary was from0to2.9strips averaging1.14±0.75strips. The LMVD in area around cancer was significantly more than thecentral area (P<0.01) and the LMVD in area around cancer significantly morethan normal breast tissue (P<0.01), there was significant difference statistically.The LMVD of centre cancer was more than normal tissue (P>0.05), but thedifference was not significant. The positive correlation between axillary lymph node staging and LMVD around the cancer had significant differencestatistically (r=0.757,P<0.01). There is positive correlation between VEGF-C、D of breast cancer and LMVD.The same as LMVD and axillary lymph nodestaging. Conclusion:1.VEGF-C、 D were all expressed in the cytoplasm ofbreast cancer cells. The correlation between LMVD in the center and thataround(more than center) the cancer had significant difference statistically.2.Positive correlation between VEGF-C、D and LMVD. The same as LMVD andaxillary lymph node staging.3. There is no positive correlation betweenVEGF-C、D of breast cancer and clinical grade and ER and PR and CerbB-2.There is positive correlation between LMVD of breast cancer and clinicalgrade,but no positive correlation with ER and PR and CerbB-2.