title: Chalkley microvessel but not lymphatic vessel density correlates with axillary lymph node metastasis in primary breast cancers.
abstract: This study aimed to investigate tumor microvessel density (MVD) and lymphatic vessel density (LVD) using the Chalkley method as predictive markers for the risk of axillary lymph node metastasis and their relationship to other clinicopathological parameters in primary breast cancer cases. Forty two node-positive and eighty node-negative breast cancers were immunostained for CD34 and D2-40. MVD and LVD were counted by the Chalkley method at x400 magnification. There was a positive significant correlation of the MVD with the tumor size, coexisting ductal carcinoma in situ (DCIS) and lymph node metastases (P<0.05). In multivariate analysis, the MVD (2.86-4: OR 5.87 95%CI 1.05-32; >4: OR 20.03 95%CI 3.47-115.6), lymphovascular invasion (OR 3.46, 95% CI 1.13-10.6), and associated DCIS (OR 3.1, 95%CI 1.04-9.23) independently predicted axillary lymph node metastasis. There was no significant relationship between LVD and axillary lymph node metastasis. However, D2-40 was a good lymphatic vessel marker to enhance the detection of lymphatic invasion compared to H and E staining. In conclusion, MVD by the Chalkley method, lymphovascular invasion and associated DCIS can be additional predictive factors for axillary lymph node metastases in breast cancer. No relationship was identified between LVD and clinicopathological variables, including axillary lymph node metastasis.
authors.affiliation: Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. ksamornm@medicine.psu.ac.th
authors.forename: Samornmas
authors.initials: S
authors.lastname: Kanngurn
authors.forename: Paramee
authors.initials: P
authors.lastname: Thongsuksai
authors.forename: Siripong
authors.initials: S
authors.lastname: Chewatanakornkul
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived; D001365:Axilla; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000098:blood supply / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000150:complications / Q000556:secondary*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000150:complications*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology*; D055806:Microvessels / Q000473:pathology*; D009361:Neoplasm Invasiveness / Q000175:diagnosis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D042461:Vascular Endothelial Growth Factor A; C500987:monoclonal antibody D2-40