Analysis Of The Formation Mechanism And Clinical Features Of Breast Cancer Microcalcification

Background:The formation mechanism of microcalcification in breast diseases has not been clearly defined at present.However,studies have shown that microcalcification of the mammary gland is associated with Epithelial-mesenchymal transition(EMT).Invasive breast cancer with microcalcification has a higher risk of metastasis and a poorer prognosis.This is also a widely accepted view at home and abroad.Objective:Breast microcalcification is usually considered as one of the common imaging manifestations of early breast cancer.The subjects of this study were patients with different types of breast microcalcification.By studying the relationship between breast microcalcification and Epithelial-mesenchymal transition(EMT),the study provides clues for the formation mechanism of various breast microcalcifications.The prognosis and risk of recurrence and metastasis in such patients can be assessed by analyzing the clinical characteristics of microcalcification in invasive carcinoma of breast.Method:1.We collected postoperative specimens of patients with four types of breast diseases who were hospitalized in the department of breast surgery of the first affiliated hospital of dalian medical university from 2013 to 2017.The patients were divided into 4 groups according to disease type(? group: invasive breast cancer with microcalcification,? group: intraductal breast cancer with microcalcification,? group: benign breast disease with microcalcification,? group: invasive breast cancer with non-calcification),with 25 cases in each group.2.We sliced the paraffin block of each specimen and performed immunohistochemical staining respectively on the sliced specimen by Anti-Collagen? antibody,Anti-beta Catenin antibody,Anti-RUNX2 antibody,Anti-ALP antibody,Anti-BMP2 antibody,Anti-Osteopontin antibody.3.Read the film under the microscope: The expression intensity of each antibody was divided into four grades,namely negative(-),weak positive(1+),medium positive(2+)and strong positive(3+).We recorded data in groups and compared the experimental results of samples in pairs,in order to analyze the differences in the occurrence of EMT between the four groups.We divided the ?,?,and ? groups into the microcalcification group and the ? group as the non-calcification group,and then compared the difference of EMT between microcalcification group and noncalcification group.Statistics was completed by SPSS 22.0 software.4.We collected the patients' clinical data of invasive breast cancer with microcalcification group and invasive breast cancer with non-calcification group,as well as compared the differences in age,histological classification,molecular typing,tumor size,axillary lymph node metastasis,and immunohistochemical indexes between the two groups.Result:100 cases were divided into invasive breast cancer with microcalcification(? group),intraductal breast cancer with microcalcification(? group),benign breast disease with microcalcification(? group),and invasive breast cancer with noncalcification(? group),25 cases in each group.(1)By comparing the immunohistochemical results of the four groups of samples,the distribution of anticollagen ? antibody,anti-beta Catenin antibody,anti-ALP antibody and antiOsteopontin antibody in the mesenchyme were statistically different among the four groups(P<0.05).In the epithelium,there is a statistically significant difference in the distribution of anti-ALP antibody and anti-osteopontin antibody.There is no statistically significant difference in the distribution of anti-BMP2 antibody and anti-RUNX2 antibody among breast types.(2)Further pairwise comparison between the groups revealed that the distribution of anti-collagen ? antibody and anti-beta catenin antibody are ? group>? group,? group>? group,? group>? group,anti-ALP antibody is ? group>? group,anti-osteopontin antibody is ? group>? group,? group>? group,? group>? group.In the epithelium,the distribution of anti-ALP antibody is ? group>? group and anti-osteopontin antibody is ? group>? group,? group>? group,? group>? group.There was no significant difference in other groups.(3)The results were obtained by comparing the microcalcification group with non-calcification group: In the mesenchyme,the distribution of anti-collagen ? antibody,anti-beta catenin antibody and anti-ALP antibody are microcalcification group>non-calcification group.In the epithelium,the distribution of anti-ALP antibody is non-calcification group>microcalcification group.There is no statistically significant difference in the distribution of anti-BMP2 antibody,anti-RUNX2 antibody and anti-osteopontin antibody between two groups.(4)Comparing the clinical characteristics between the invasive breast cancer with microcalcification group and invasive breast cancer with non-calcification group,there are statistically significant differences between the two groups in molecular typing,axillary lymph node metastasis,and ki-67 expression(P < 0.05),but no statistically significant differences in age,tumor size,histological classification,ER,PR,and Her-2 expression.Conclusion:1.The distribution of anti-collagen ? antibody,anti-beta catenin antibody and anti-ALP antibody in the microcalcification group are higher than non-calcification group.It is suggested that EMT level in the microcalcification group is higher than noncalcification group.2.There is no statistically significant difference of EMT level among invasive breast cancer with microcalcification,intraductal breast cancer with microcalcification and benign breast disease with microcalcification.There was no significant correlation between EMT and malignant degree of breast diseases.3.Compared with non-calcified invasive breast cancer,invasive breast cancer with microcalcification is more likely to have axillary lymph node metastasis,higher Ki-67 expression,less Luminal A type and more Luminal B type.These findings suggest that invasive breast cancer with microcalcification has a higher risk of recurrence and metastasis,and a poorer prognosis.Microcalcification may be a factor of poor prognosis in clinical breast cancer.4.When type ? collagen,Catenin and ALP expression increased in the stromal microenvironment in breast cancer,the risk of axillary lymph node metastasis will be higher.