Comparative Analysis Of Clinicopathological Features Between Central Necrotizing Breast Cancer And Basal Cell-like Breast Cancer

Purpose:To study the relationship between the histological and clinical features of centrally necrotizing carcinoma of the breast(CNC)and basal-like breast cancer(BLBC),and the relationship between HIF-1α,BRCA1 and VEGF and their clinicopathological characteristics,and to analyze the difference and correlation of HIF-1α,BRCA1 and VEGF expression in CNC and BLBCMethods:Paraffin specimens of invasive ductal carcinoma diagnosed in the First Affiliated Hospital of Bengbu Medical College from March 2013 to August 2020 were screened,and 69 cases of CNC specimens with necrotic area greater than 70%,48 cases of BLBC specimens and 36 cases of invasive ductal carcinoma with focal necrosis were selected(as controls),both of which had necrotic area less than 30%of the total tumor area.The expression levels of HIF-1α,BRCA1 and VEGF in the samples and the expression levels of CK5/6 and EGFR in CNC and control groups were detected by immunohistochemical staining and the data were analyzed by SPSS 25.0Results:1.The morphology of CNC and BLBC in HE sections was similar,BLBC accounted for more than half of the molecular typing,and there were significant differences in the expression of ER,PR and HER-2 between the two(P<0.05),and there were no differences in age,tumor size,histological grade,lymph node metastasis,clinical stage,and pathological stage(P>0.05),there were significant differences in tumor size and histological grade between CNC and the control group(P<0.05),there was no significant difference in other parameters(P>0.05)2.There was no statistical difference in BRCA1 positive expression between the CNC group and the BLBC group(P>0.05),there was statistically significant difference between the CNC group and the control group(P<0.05)3.HIF-1α expression was significantly different between CNC and BLBC as well as in the control group(P<0.05).HIF-1α expression was correlated with histological grade in CNC(P<0.05),and was associated with lymph node status,clinical stage and pathological stage in BLBC(P<0.05)4.There was no significant difference in VEGF expression between CNC,BLBC and the control group(P>0.05),and its expression was correlated with lymph node metastasis in CNC(P<0.05),was associated with lymph node metastasis,clinical stage and pathological stage in BLBC(P<0.05)5.HIF-1α was positively correlated with VEGF expression in BLBC and control group(P<0.05),there was no correlation between the two in CNC(P>0.05),the expression of BRCA1 and VEGF was negatively correlated in CNC,BLBC and control group(P<0.05)Conclusion:1.CNC and BLBC are similar in histological morphology2.Most of the CNC molecular typing was BLBC,while other subtypes accounted for less.3.There was no statistical difference in BRCA1 expression between CNC and BLBC,and targeted treatment of BRCA1 in BLBC may also have considerable effect in CNC4.HIF-1A expression is significantly different between CNC and BLBC,which may serve as a new entry point to identify the two5.There was a significant correlation between VEGF expression in BLBC and HIF-1A,but no correlation was found in CNC.We speculated that large area necrosis in CNC might be related to insufficient angiogenesis.