The Value Of High-frequency Color Doppler Ultrasound Combined With Lymphatic Microvessel Density Derterming Axillary Lymph Nodes Metastases Of Breast Cancer

Purpose: To investigate the relationship between the high-frequency color Doppler characteristics of invasive breast cancer and axillary lymph nodular metastases. The breast cancer specimen were stained immunohistochemically by means of vascular endothelial growth factor C(VEGF-C) and vascular endothelial growth factor receptor 3(VEGFR-3). Comparisons were done between the lymphatic microvessel density(LMVD) and the high-frequency color Doppler characters of breast cancer. The relationship between them can provide more valuable information for early diagnosis of breast cancer metastases.Materials and Methods: 59 breast cancer patients confirmed pathologically were recruited in this study, among which axillary lymph nodular metastases were found in 32 cases. Sonography was performed with Philips HDI 3000 with transducer frequency 5-12MHz.They all underwent color Doppler examination one week before surgery. The size, border, internal echo of the tumor and the blood stream distribution in the tumoral and peritumoral region were recorded. All the data mentioned above were saved and analyzed off-linely. The VEGF-C, VEGFR-3 and CD34 antibody were utilized in our immunohistochemical experiment. We analyzed the correlation between the VEGF-C, LMVD and the axillary lymph node metastases, then combined the high-frequency color Doppler characters with the immunohistochemical results to seek the relationship between the ultrasound characters and axillary lymph nodular metastases of breast carcinoma.Results: The tumoral size, border were related to axillary lymph nodular metastases. The axillary lymph node metastases occurrence probabilities of tumors larger than 2cm were higher than the tumors no more than 2cm or less (P=0.007). The tumors with ill defined border or with spiculated had higher axillary lymph node metastatic probabilities than tumors with well defined margin (P=0.031). The calcification in the lesions had no evident correlation with axillary lymph nodular metastases. The color Doppler manifestation and axillary lymph nodular metastases in 59 infiltrative breast cancer demonstrated as below. The blood stream signal in tumors with axillary lymph node metastases was mostly grade â…¡ and â…¢, while the signal in tumors without metastases was mostly grade 0 and â… . The signal in tumors larger than 2cm was almost grade â…¡ and â…¢, however, the signal in tumors no more than 2cm or less was all grade 0 and â… .It showed that the level of inner blood stream signal was positively interrelated with the size of tumor, that means, the larger the tumor was, the more plentiful color blood stream it had and the higher probability of lymph node metastases was. The VEGF-C, LMVD and lymph node metastases in infiltrative breast cancer demonstrated as bellows. The VEGF-C expression ratios in infiltrative breast cancer with axillary lymph node metastases were higher than lesions without metastases. The LMVD were also higher in tumors with metastases than ones without metastases. Tumors with ill defined boundary or with spiculated had higher LMVD than tumors with clear outline. The LMVD were higher in tumors larger than 2cm than tumors no more than 2cm or less. Conclusions: 1. The size, border of infiltrative breast cancer has close correlation with axillary lymph node metastases. The axillary lymph node metastases occurrence probabilities of tumors larger than 2cm were higher than the tumors no more than 2cm or less. The tumors with ill defined border or with spiculated had higher axillary lymph node metastatic probabilities than tumors with clear outline. The calcification in the lesions had no evident correlation with axillary lymph nodular metastases.2. Color and energy Doppler ultrasound are of certain value in predicting axillary lymph node metastasis of breast cancer. The tumors larger than 2cm had more plentiful blood stream signal than tumors no more than 2cm or less. The larger the tumor is, the more plentiful color blood stream is, which means more larger possibility of lymph node metastases.3. VEGF-C...