title: Microvessel proliferation by co-expression of endothelial nestin and Ki-67 is associated with a basal-like phenotype and aggressive features in breast cancer.
abstract: BACKGROUND
  To quantify tumour angiogenesis, microvessel density (MVD) has been widely used. We here present a novel angiogenesis marker, microvessel proliferation (MVP), based on dual immunohistochemical staining of nestin and Ki-67. Immature endothelial cells express nestin, and when co-expressed with the proliferation marker Ki-67, the number of proliferating immature blood vessels can be measured.
  
  
  METHODS
  Microvessel proliferation was evaluated in 178 breast cancer samples and estimated by vascular proliferation index (VPI), the ratio between the number of vessels containing proliferating endothelial cells and the total number of immature vessels.
  
  
  RESULTS
  High VPI was strongly associated with several markers of aggressive breast cancer, such as negative oestrogen receptor (ER) status (p = 0.003), high tumour cell proliferation by Ki-67 (p = 0.004), high p53 expression (p = 0.001), and five profiles for the basal-like phenotype (odds ratios (OR); range 3.4-6.3). Also, high VPI was significantly associated with interval detected breast cancer compared with screening detected lesions (p < 0.0005), and adverse outcome in univariate and multivariate survival analysis (p = 0.034 and p = 0.022, respectively).
  
  
  CONCLUSIONS
  Microvessel proliferation is a novel marker of ongoing angiogenesis and was associated with aggressive tumour features, basal-like phenotypes, interval presentation, and prognosis in this series of breast cancer.
authors: The Gade Institute, Section for Pathology, University of Bergen, Haukeland University Hospital, Bergen, Norway.
authors: K
authors: K
authors: Krüger
authors: I M
authors: IM
authors: Stefansson
authors: K
authors: K
authors: Collett
authors: J B
authors: JB
authors: Arnes
authors: T
authors: T
authors: Aas
authors: L A
authors: LA
authors: Akslen
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000098:blood supply / Q000737:chemistry* / Q000473:pathology; D002277:Carcinoma / Q000098:blood supply / Q000737:chemistry* / Q000473:pathology; D049109:Cell Proliferation; D004727:Endothelium / Q000737:chemistry* / Q000503:physiopathology; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D055806:Microvessels / Q000737:chemistry* / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D060787:Neoplasm Grading; D009389:Neovascularization, Pathologic / Q000503:physiopathology; D064231:Nestin / Q000032:analysis*; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D019394:Ki-67 Antigen; D064231:Nestin; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D016159:Tumor Suppressor Protein p53