【摘要】 目的　研究血管形成和纤维蛋白降解作用与乳腺癌侵袭转移的关系。方法　应用免疫组化方法,检测1 1 0例原发性乳腺癌患者中尿激酶型纤溶酶原激活物(uPA)和微血管密度(MVD)的表达,并结合临床、病理及随访资料进行分析。结果　1 1 0例患者中,uPA高表达者5 9例,占5 3.6 %;低表达者5 1例,占4 6 .4 %。MVD计数高者5 3例,占4 8.2 %;计数低者5 7例,占5 1 .8%。uPA表达与肿瘤大小、淋巴转移和TNM分期有显著相关性,MVD与肿瘤大小、TNM分期有显著相关性,二者表达与患者年龄、月经状况和激素受体状况无关。uPA和MVD高表达者的无复发生存期均低于低表达者的生存期,特别是uPA和MVD均为高表达者更易复发转移。多因素分析显示,uPA和MVD是影响无复发生存期的主要因素。结论　血管形成和纤维蛋白降解作用与乳腺癌的侵袭转移行为密切相关,uPA和MVD可能是预测乳腺癌患者复发转移的独立预后因素。更多还原

【Abstract】 Objective To investigate the relation between angiogensis, fibrinolysis and invasion/metastasis in breast cancer. Methods The expression of urokinase-type plasminogen activator (uPA) and microvascular density (MVD) was immunohistochemically studied in 110 patients with primary breast cancer. Results High uPA expression was found in 59 patients (53.6%), and weak expression in 51 patients(46.4%). Strong MVD expression was found in 53 patients(48.2%), and weak expression in 57 patients(51.8%). The correlation between uPA expression and tumor size, lymph node status, TNM stage was statistically significant. Expression of MVD was also significantly associated with tumor size and TNM stage. Neither age related to GDDP, menopausal status nor PR ER status was significantly with uPA and MVD expression. Patients with strong expression of uPA and/or MVD had a significantly shorter relapse-free survival than those with weak expression of uPA and/or MVD. Especially, patients with strong expression of both uPA and MVD were likely to develop reccurence and metastasis. Multivariate analysis showed that uPA and MVD were two independent prognostic factors affecting the relapse-free survival. Conclusion Angiogensis and fibrinolysis were closely assotiated with invasion and metastasis of breast cancer. uPA and MVD may be two strong and independent biologic markers in predicting postoperative relapse and metastasis of breast cancer.更多还原