Angiogenesis and hypoxia in lymph node metastases is predicted by the angiogenesis and hypoxia in the primary tumour in patients with breast cancer

被引:47
作者
Van den Eynden, GG
Van der Auwera, I
Van Laere, SJ
Colpaert, CG
Turley, H
Harris, AL
van Dam, P
Dirix, LY
Vermeulen, PB
Van Marck, EA
机构
[1] Gen Hosp St Augustinus, Dept Pathol, Ctr Oncol, Translat Canc Res Grp, B-2610 Antwerp, Antwerp, Belgium
[2] Univ Antwerp, Univ Antwerp Hosp, Pathol Lab, Translat Canc Res Grp, B-2610 Antwerp, Antwerp, Belgium
[3] Univ Oxford, John Radcliffe Hosp, Nuffield Dept Clin Lab Sci, Oxford OX3 9DU, England
[4] John Radcliffe Hosp, Weatherall Inst Mol Med, Canc Res UK Growth Factor Grp, Oxford OX3 9DU, England
关键词
angiogenesis; hypoxia; lymph node metastasis; breast cancer;
D O I
10.1038/sj.bjc.6602828
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Hypoxia and angiogenesis are important factors in breast cancer progression. Little is known of hypoxia and angiogenesis in lymph node metastases of breast cancer. The aim of this study was to quantify hypoxia, by hypoxia-induced marker expression levels, and angiogenesis, by endothelial cell proliferation, comparing primary breast tumours and axillary lymph node metastases. Tissue sections of the primary tumour and a lymph node metastasis of 60 patients with breast cancer were immunohistochemically stained for the hypoxia-markers carbonic anhydrase 9 (CA9), hypoxia-inducible factor-1 alpha (Hif-1 alpha) and DEC-1 and for CD34/Ki-67. Endothelial cell proliferation fraction (ECP%) and tumour cell proliferation fraction (TCP%) were assessed. On haematoxylin-eosin stain, the growth pattern and the presence of a fibrotic focus were assessed. Hypoxia-marker expression, ECP% and TCP% in primary tumours and in lymph node metastases were correlated to each other and to clinico-pathological variables. Median ECP% and TCP% in primary tumours and lymph node metastases were comparable (primary tumours: ECP% = 4.02, TCP% = 19.54; lymph node metastases: ECP% = 5.47, TCP% = 21.26). ECP% correlated with TCP% (primary tumours: r = 0.63, P < 0.001; lymph node metastases: r = 0.76, P < 0.001). CA9 and Hif-1 alpha expression were correlated (primary tumours P = 0.005; lymph node metastases P < 0.001). In primary tumours, CA9 and Hif-1 alpha expression were correlated with DEC-1 expression (P = 0.05), presence of a fibrotic focus (P < 0.007) and mixed/expansive growth pattern (P < 0.001). Primary tumours and lymph node metastases with CA9 or Hif-1 alpha expression had a higher ECP% and TCP% (P < 0.003); in primary tumours, mixed/expansive growth pattern and fibrotic focus were characterised by higher ECP% (P < 0.03). Furthermore, between primary tumours and lymph node metastases a correlation was found for ECP%, TCP%, CA9 and Hif-1 alpha expression (ECP% r = 0.51, P<0.001; TCP r = 0.77, P<0.001; CA9 and Hif-1 alpha P<0.001). Our data demonstrate that the growth of breast cancer lymph node metastases is angiogenesis dependent and that angiogenesis and hypoxia in the primary tumour predict angiogenesis and hypoxia in the lymph node metastases. Together with previous findings in breast cancer liver metastases, which grow in 96% of cases angiogenesis independently, these data suggest that both the intrinsic growth characteristics and angiogenic potential of breast cancer cells and the site-specific tumour microenvironment determine angiogenesis and hypoxia in breast cancer.
引用
收藏
页码:1128 / 1136
页数:9
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