APC And Phenotype Changes Of Breast Cancer Ablated In Situ By High Intensity Focused Ultrasound

OBJECTIVE ⑴ To observe the number changes of antigen presenting cells(APC) in treated-tumor and axillary lymph nodes after the local treatment of high intensity focused ultrasound(HIFU) for patients with breast cancer. (2)To study the phenotype changes of APC in treated-tumor and axillary lymph nodes after HIFU treatment for patients with breast cancer. (3) To explore the immunogenicity change of breast cancer by studying the expression of CA15-3 in breast cancer ablated by HIFU .METHODS A total of 48 female patients with breast cancer were pathologically diagnosed with needle biopsy. Among them, 23 patients with breast cancer underwent HIFU treatment one to two weeks before modified radical mastectomy(HIFU group),25 patients only underwent modified radical mastectomy(control group). After the operation, thespecimens of both tumor lesions and axillary lymph node were collected, fixed in 10% formalin, embedded in paraffin ,and cut into 0.5μm thick slices. ⑴Monoclonal antibody CD68,CD20 and polyclonal antibody S-100 were used respectively to study the number of macrophage(MФ) ,B lymphocyte(BL) and dendritic cell(DC) in both treated breast cancer tissue and axillary lymph nodes by streptavidin peroxidase (SP) immunohistochemical method. (2) For determining the phenotype characters, we used monoclonal antibody HLA-DR,CD80 and CD86 to study the phenotype changes of DC,MФ and BL by immunohistochemistry double labeling technique.(3)Monoclonal antibody CA15-3 was uses to detect the expression of tumor associated antigen CA15-3 in breast cancer treated by HIFU. All observed data were shown as means plus or minus the standard deviation. The differences in statistical and percentage data of two groups were analyzed by using t and X2 text by respectively.RESULTS (1) In breast cancer tissue, the average number of DC,MФ and BL was DC 68.1±26.2/mm2,MФ203.2±72.2/mm2,BL 196.0±105.3/mm2 respectively in HIFU group, while an average number DC 45.2±26.9/mm2,MФ 119.5±63.1/mm2,BL 126.0±76.5/mm2 correspondently in control group. The difference was highly significant in both group (p<0.01). In HIFU group, the positive rate of HLA-DR,CD80and CD86 expressed on DC was 88.5±8.9℅,52.7±16.0℅,41.3±8.6℅, expressed on MФ was 89.9±8.9℅,47.3±14.3℅,34.9±19.2℅, expressed on BL was 96.8±11.6℅,39.0±17.3℅,47.8±12.4℅ respectively. But in control group, the positive rate of HLA-DR,CD80 and CD86 expressed on DC was 70.5±10.1℅,20.9±12.3℅,24.8±6.0℅, expressed on MФ was 70.8±10.6℅,16.7±10.4℅,19.0±16.4℅, expressed on BL was 85.2±15.7℅,16.5±12.4℅,26.3±11.8℅respectively. Compared with the control group, the positive rate of HLA-DR,CD80 and CD86 expressed on DC, MФ and BL respectively were significantly higher within the treated-tumor in the HIFU group(p<0.01). (2) In axillary lymph nodes, the average number of DC,MФ and BL was DC 206.7±78.6/mm2,MФ 376.4±135.2/mm2,BL 2490.5±734.6/mm2 respectively in HIFU group, with an average number DC 62.7±53.3/mm2,MФ142.7±97.6/mm2,BL 2012.2±583.5/mm2 correspondently in control group. Significant difference was found in both group(p<0.01). In HIFU group, the positive rate of HLA-DR,CD80 and CD86 expressed on DC was 92.2±16.5℅,48.9±15.2℅,44.9±17.2℅, expressed on MФwas 96.2±14.5℅,44.1±16.8℅,35.0±16.2℅,expressed on BL was 97.7±14.3℅,39.9±15.9℅,30.0±12.5℅ respectively. on the contrary, the positive rate of LA-DR,CD80 and CD86 expressed on DC in control group was 77.0±17.5℅,15.2±10.1℅,22.6±13.5℅, expressed on MФ was 75.5±18.0℅,18.1±13.8℅,23.6±13.0℅,expressed on BL was 85.5±16.2℅,16.3±12.4℅,19.7±12.1℅respectively. Compared with the control group, the positive rate of HLA-DR,CD80 and CD86 expressed on DC,MФ and BL was significantly higher in axillary lymph nodes in HIFU group(P<0.01). (3)In the HIFU group, the positive rate of CA15-3 expression in the treated-tumor was 52℅. On the contrary, the positive rate of CA15-3 expression was 92℅ in the control group.