Prognosis Value Of Color Pixel Density In Breast Invasive Ductal Carcinoma

Objective: To discuss clinical application value about quantified indicator CPD of doppler ultrasound evaluating tumor angiogenesis and preoperative prognosis,by studying the correlation between color pixel density and vascular endothelial growth factor,some clinical prognostic indicator (histology grading,TNM stage,tumor size,lymph node metastasis,ER,PR,C-erbB-2) of breast invasive ductal carcinoma.Materials and methods:52 patients with breast invasive ductal carcinoma were performed by doppler ultrasound. The features of blood flow in neoplasm were evaluated by color doppler ultrasonography, the most prominent internal and peripheral vessels of the neoplasm were examined with pulse wave doppler to judge the quality of the signal, measure the peak systolic velocity,resistive index .The number, shape and distribution of the internal and peripheral vessels of the neoplasm were tested, and the area with the richest blood flow was chosen to calculate color pixel density with computer-assistant of power doppler ultrasonography .The vascular endothelial growth factor was measured in surgical specimen after immunohistochemical staining using anti-factor VEGF and evaluated the correlation between color pixel density and VEGF,some clinical prognostic indicator (histology grading,TNM stage,tumor size,lymph nodes metastasis,ER,PR,C-erbB-2) of breast invasive ductal carcinoma. Results:(1)The grade of blood stream signal is increasing following histology grading growing, and the blood stream signal has statistical significant in the different histology grading(H=8.135,P=0.017). (2)The peak systolic velocity and resistive index of vascular structures be calculated by pulse wave doppler ,there are 40 tumors of PV﹥20cm/s,RI≥0.7,showing rate 76.9%,and center,penetrating vascular structure is most significance, especially center , but these index have no statistical significant(P﹥0.05).(3)The higher of histology grading and TNM stage ,the greater of VEGF-positive and CPD, and has statistical significant in the different histology grading and TNM stage(P﹤0.01).(4) Color pixel density as quantified indicator of color power doppler showed a good correlation with the vascular endothelial growth factor(rs=0.851,P=0.000).(5) ER,PR,C-erbB-2 positive rate has no statistical significant in the different histology grading and TNM stage, but lymph nodes is opposite;(6) Color pixel density is correlated significantly with tumor size,lymph nodes metastasis,C-erbB-2,but there is not the correlation with ER,PR.Conclution: By utilizing color Doppler ultrasound for analyzing the blood stream shaping and dynamics of the patients with breast invasive ductal carcinoma can provide more information in diagnosis and differential diagnosis ,but clinical prognostic evaluation is helpless; Color pixel density as quantified indicator showed a good correlation with the vascular endothelial growth factor, which means to color pixel density be able to assess clinical prognostic; Color pixel density is a reliable clinical prognostic indicator ,because of a good correlation with tumor size,histology grading,lymph nodes metastasis,C-erbB-2.