Predictors of disease progression in ductal carcinoma in situ of the breast and vascular patterns
Predictors of disease progression in ductal carcinoma in situ of the breast and vascular patterns
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DOI：
10.1016/j.humpath.2011.06.004
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发表时间：
2012-04-01
期刊：
影响因子：
3.3
通讯作者：
Oktay, Maja H.
中科院分区：
文献类型：
--
作者：
Adler, Esther H.;Sunkara, Jaya L.;Oktay, Maja H.
乳腺癌诱导的血管生成有助于满足肿瘤日益增长的代谢需求，并随着良性导管向导管原位癌(DCIS)和导管原位癌向浸润性癌的恶性转化而逐渐增加。关于低、中、高级别导管原位癌在血管生成方面的差异，有相互矛盾的数据。如果血管生成与导管原位癌的进展有关，则具有较高侵袭性生物学潜能的导管原位癌类型与侵袭性较弱的导管原位癌具有不同的血管形态。在这项研究中，我们根据Tsikitis和Chung(Am J Clin Oncol2006；29：305)提出的标准，将51例导管原位癌分为低度(10-20年进展为浸润性癌)、中等或高度侵袭性(2-5年进展为浸润性癌)，其中考虑了核分级、有丝分裂率、Ki-67、HER2Neu、P53、雌激素和孕激素受体的表达。我们将这三组导管原位癌与导管周围和间质血管的范围以及血管破裂的存在和类型联系起来。未发现导管原位癌的侵袭性生物学行为与任何血管类型有关。此外，血管类型与侵袭性、微血管密度或预后(局部复发、浸润性癌或转移性疾病)的分类之间没有相关性。为了验证我们的队列，我们通过相互关联来确认所有测量的攻击性参数的预期相关性。综上所述，导管原位癌的血管形态与侵袭性行为的预测因子无关，提示导管原位癌的生物学潜能与血管生成无关。(C)2012 Elsevier Inc.保留所有权利。
Breast carcinoma induced angiogenesis helps meet growing metabolic needs of tumors and progressively increases with malignant transformation of benign ducts to ductal carcinoma in situ (DCIS) and ductal carcinoma in situ to invasive carcinoma. There are conflicting data regarding the difference in angiogenesis in low-, intermediate-, and high-grade ductal carcinoma in situ. If angiogenesis is related to ductal carcinoma in situ progression, the types of ductal carcinoma in situ with more aggressive biologic potential would have different vascular patterns than the less aggressive ones. In this study, we classified 51 cases of ductal carcinoma in situ as low (10-20 years to progression to invasive carcinoma), moderate, or high aggressive (2-5 years to progression to invasive carcinoma), based on criteria outlined by Tsikitis and Chung (Am J Clin Oncol 2006; 29:305), which takes into account nuclear grade, mitotic rate, Ki-67, Her2Neu, P53, estrogen, and progesterone receptor expression. We correlated these 3 groups of ductal carcinoma in situ with the extent of periductal and stromal vascularity and the presence and type of vascular breaks. No association of aggressive biologic behavior of ductal carcinoma in situ with any vascular pattern was found. Moreover, no correlation was found between vascular patterns and classifiers of aggressiveness, microvascular density, or outcome (local recurrence, invasive carcinoma, or metastatic disease). To validate our cohort, we confirmed expected correlations of all measured parameters of aggressiveness by correlating them with each other. In summary, vascular patterns in ductal carcinoma in situ do not correlate with the predictors of aggressive behavior, suggesting that the biologic potential of ductal carcinoma in situ is independent of angiogenesis. (C) 2012 Elsevier Inc. All rights reserved.