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目的 研究血管形成和纤维蛋白降解作用与乳腺癌侵袭转移的关系。方法 应用免疫组化方法,检测1 1 0例原发性乳腺癌患者中尿激酶型纤溶酶原激活物(uPA)和微血管密度(MVD)的表达,并结合临床、病理及随访资料进行分析。结果 1 1 0例患者中,uPA高表达者5 9例,占5 3.6 %;低表达者5 1例,占4 6 .4 %。MVD计数高者5 3例,占4 8.2 %;计数低者5 7例,占5 1 .8%。uPA表达与肿瘤大小、淋巴转移和TNM分期有显著相关性,MVD与肿瘤大小、TNM分期有显著相关性,二者表达与患者年龄、月经状况和激素受体状况无关。uPA和MVD高表达者的无复发生存期均低于低表达者的生存期,特别是uPA和MVD均为高表达者更易复发转移。多因素分析显示,uPA和MVD是影响无复发生存期的主要因素。结论 血管形成和纤维蛋白降解作用与乳腺癌的侵袭转移行为密切相关,uPA和MVD可能是预测乳腺癌患者复发转移的独立预后因素。
Objective To investigate the relationship between angiogenesis and fibrin degradation and invasion and metastasis of breast cancer. Methods The expression of urokinase-type plasminogen activator (uPA) and microvessel density (MVD) in 110 primary breast cancer patients was detected by immunohistochemistry and analyzed by clinical, pathological and follow-up data . Results Among the 110 patients, 59 cases were highly expressed uPA, accounting for 53.6%; 51 cases were low expression, accounting for 46.4%. The highest MVD count was 53, accounting for 4 8.2%. The lower count was 57, accounting for 51.8%. There was a significant correlation between uPA expression and tumor size, lymphatic metastasis and TNM staging. MVD had significant correlation with tumor size and TNM staging. The expression of uPA had no relation with patient’s age, menstrual status and hormone receptor status. The relapse-free survival of patients with high expression of uPA and MVD were lower than those of low expression, especially the patients with high expression of uPA and MVD were more likely to relapse and metastasis. Multivariate analysis showed that uPA and MVD were the main factors affecting recurrence-free survival. Conclusion Angiogenesis and fibrin degradation are closely related to the invasion and metastasis of breast cancer. UPA and MVD may be independent predictors of recurrence and metastasis in patients with breast cancer.