Expressions of COX-2 in primary tumor and axillary lymph node tissues of breast cancer and significance / 吉林大学学报(医学版)

Objective To detect COX-2 expressions in primary tumor and axillary lymph node tissues of breast cancer,and to study the relationship between COX-2 expression in breast cancer and lymph node metastasis.Methods The expressions of COX-2 in 9 normal breast tissues,50 primary breast cancer tissues,19 positive axillary lymph nodes and 31 negative axillary lymph nodes were detected with immunohistochemistry S-P method.Results COX-2 staining was granular and localized to the cytoplasm of tumor cells.In normal breast tissues,COX-2 staining was granular and localized to mesenchymocyte.In negative lymph nodes,COX-2 staining was granular and localized to macrophagus cytoplasm.The positive expression rates of COX-2 in normal breast tissues,primary breast cancer tissues,positive axillary lymph nodes and negative axillary lymph nodes were 11.1%,60.0%,84.2%,and 32.3%,respectively.There were significant differences of COX-2 positive expression rates between normal breast tissues,primary breast cancer tissues and positive axillary lymph nodes(P

Predictors of Axillary Lymph Node Metastases in Patients with T1 Breast Cancer

PURPOSE: In T1 tumors, the reported incidence of lymph node metastasis ranges from 6% to 31%. The authors analyzed the clinical and the pathological parameters of T1 tumors for their association with the likelihood of axillary lymph node metastases (ALNM). METHODS: The authors reviewed data from 57 patients with T1 breast carcinomas who had undergone a level I/II axillary dissection from January 1996 to March 2000. The association between the incidence of ALNM and clinical/pathologic factors (age, site, size, neoadjuvant chemotherapy, histologic grade, lymphovascular invasion, estrogen receptor status, progesterone receptor status, p53, and c-erbB-2) were analyzed by using chi-square tests. RESULTS: Approximately 42% of the 57 patients with a T1 breast carcinoma had ALNM. Chi-square tests showed that lymph node metastases were associated with tumor size (P=0.043), lymphovascular invasion (P=0.001), and expression of c-erbB-2 (P=0.026). CONCLUSION: The authors conclude that the charac teristics of the primary tumor can be used to estimate the risk of ALNM in patients with a T1 breast carcinoma. Such a risk assessment might facillitate appropriate management.

Axillary Lymph Node Metastases in Patients with T1 Breast Carcinoma: Correlation with Histopathologic and Immunohistochemical Characteristics of the Primary Tumor / 대한암학회지

PURPOSE: Axillary lymph node metastases (ALNM) are the most important prognostic indicator in breast carcinoma. Because of relatively low incidence of axillary metastasis in the patients with Tl breast carcinoma, axillary lymph node dissection is now no longer considered to be the standard treatment. A reliable prediction of ALNM.may reduce the need for axillary lymph node dissection and may facilitate to select appropriate treatment modality. We have attempted to identify histopathologic/immunohistochemical factors correlated with ALNM in the patients with Tl breast carcinoma. MATERIAL AND METHODS: Forty-one patients with Tl breast carcinoma who underwent modified radical mastectomy and axillary dissection between January 1993 and February 1999 were studied. We investigated the relationship between ALNM and the histopathologic/immunohistochemical factors (size, lymphatic-vascular invasion (LVI), histologic grade, age, estrogen receptor (ER) status, progesterone receptor (PR) status, p53 protein, cathepsin D (CD), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor (TGF)- B 2, and microvessel density (MVD)). RESULTS: Fourteen (34.2%) out of the 41 patients with Tl breast carcinoma had ALNM. There are five statistically significant factors correlated with ALNM; lymphatic-vascular invasion (P=0.002), histologic grade (P 0.047), immunohistochemical expression of CD (P=0.005) and TGF- B 2 (P=0.004), and microvessel density (P=0.002). CONCLUSION: The histopathologic/immunohistochemical features of the primary breast tumor, such as LVI, increase in MVD, TGF- B 2 and CD expression, and histologic grade might be useful predictors of ALNM in patients with Tl breast carcinoma.

The Predictor of Axillary Lymph Node Metastases in Breast Cancer

BACKGROUND: The presence of axillary lymph node metastases (ALNM) and tumor size are two most important prognostic factors in breast cancer. An axillary lymph node dissection (ALND) is usually performed in infiltrating breast cancer for the information of therapeutic decision and prediction of prognosis. However this procedure results in lymphedema of the affected upper extremity, increased axillary drainage, sensory abnormality, and pain. If the axillary lymph node status could be predicted accurately prior to an ALND, selected patients with a low probability of ALNM could be spared the procedure. The purpose of this study was to determine the association between the incidence of ALNM and 14 clinico-pathologic factors by using univariate and multivariate analysis and to investigate the possibility of using those factors as predictors for ALNM. METHODS: We reviewed data from 253 patients with breast cancer who had undergone at least a level I/II axillary dissection between 1991 and 1998. The association between the incidence of ALNM and 14 clinico-pathologic factors (age, menstruation, tumor size, palpability of tumor, tumor site, pathologic type, nuclear grade, estrogen receptor status, progesteron receptor status, p53, c-erbB-2, Ki67, Cd34, and Cathepsin D) were analyzed by using univariate and, when significant, multivariate analysis. RESULTS: Approximately 38.7% of the 253 patients with breast cancer had ALNM. Univariate analysis showed that ALNM were associated with tumor size (P<0.01), pathologic type (P<0.001), palpability (P<0.01), and nuclear grade (P<0.01). However, independent predictors of ALNM in the multivariate analysis were tumor size and pathologic type. Among the patients with smaller than 1.0 cm in the tumor size and DCIS in the pathologic type, the ALNM was not founded. CONCLUSIONS: We conclude that the characteristics of primary breast cancer can help assess the risk for ALNM. Selected patients, who are assessed to be minimal risk, might be spared a routine ALND, if the treatment decision would not be influenced by the lymph node status.