Coherent Study On The Relationship Between Color Doppler Ultrasound, Angiogenesis And Lymph Node Metastasis In Breast

ObjectiveUsing the Color Doppler Flow imaging (CDFI) to find the relationship between blood flow grading in breast tumor lumps, Micro Vessel Density (MVD) values, expression of the proteins Vascular Endothelial Growth Factor (VEGF) and Hypoxia Inducible Factor-1α(HIF-1α); Exploring the relationship between blood flow grading, breast cancer angiogenesis and metastasis to axillary lymph nodes; providing a pre-operative, non-invasive evaluation of active angiogenesis in breast cancer and contemplating the effects of chemotherapy and radiotherapy, thus giving scientific evidence for prognosis.Methods38 cases of breast cancer patients, in which ipsilateral axillary lymph node metastasis has been pathologically confirmed in 18 cases, 20 cases had no metastasis. CDFI was used preoperatively to detect of blood flow and its distribution within the tumor. Postoperatively, immunohistochemical method was used for detection of MVD values and Optical Density (OD) for VEGF, HIF-1αprotein expression in the tissue and analyze their correlation with blood flow grade, histological grade, lymph node metastasis, as well finding the correlation between these two investigation methods.Result(1) The mean difference of MVD values, between different blood flow grades of breast cancer lumps, was statistically significant (P<0.001). MVD values for blood flow grade 3 was higher than MVD values of grade 0 and grade 2 groups; The OD values for the expression of VEGF and HIF-1αwas statistically significant (P<0.001). OD values for blood flow grade 3 was higher than those of blood flow grade 0 and 1 respectively, OD values in blood flow group 2 was higher than in blood flow grade 0.(2) Breast tumor lumps with different histological grading values had statistically significant difference in mean MVD values (P<0.01). MVD values in histological grade III was higher than in grade I and II respectively. OD values for expression of VEGF between different histological grades were statistically significant (P<0.01), OD values of histological grade were higher compared to histological grade I and II respectively. OD values for expression of HIF-1αof different histological grades was statistically significant (P<0.001), OD values increased with increasing histological grading. A linear relationship exists between blood flow in tumor and histological grading. Blood flow grade increased with increasing histological grading (P<0.01).(3) MVD values for lymph node metastasis -positive group was significantly higher than MVD values in lymph node metastasis-negative group (P<0.001). OD values for VEGF protein expression in lymph node metastasis-positive group was significantly higher than OD values of lymph node metastasis-negative group (P<0.05). OD values for HIF-1αprotein expression, in lymph node metastasis positive group were much higher than it lymph node metastasis-negative group (P<0.05). Axillary lymph node metastatic rate for different blood flow grades was statistically significant (P<0.05). Lymph node metastatic rate for blood flow grade 3 was higher compared to grade 0.ConclusionBlood flow grade in breast tumor lumps is highly correlated with MVD values, expression of HIF-1αand VEGF, histological grade and lymph node metastasis. Blood flow grading can not only reflect the level of angiogenesis in breast tumor lumps, but can also reflect degree of malignancy and metastasis situation. It can help in preoperative diagnosis and can provide non-invasive, valuable radiological information which can be used to assess prognosis.