Gustoća limfnih i malih krvnih žila u stromi tumora i peritumoralnog tkiva u invazivnom karcinomu dojke bez posebnih obilježja

Abstract

Background: Peritumoral clefts are noticed in carcinomas of many organs, and were thought to be artifacts due to fi xation and preparation of slides. Today they are considered to be additional marker of malignancy and the refl ection of epithelial-stromal interaction. The hypothesis was that peritumoral clefts in breast carcinoma refl ect changes in stromal composition and characteristics, and are related to lymphangiogenesis in tumor tissue. Materials and methods: One hunderd (59% with axillary lymph nodes metastases) invasive ductal breast carcinomas of no special type were analyzed for the presence and abundance of peritumoral clefts and immunohistochemically for CD34, vimentin, smooth muscle actin (SMA) and D2-40 (podoplanin) in tumor stroma. Results: Peritumoral clefts were found in 92% of invasive carcinomatous tissue and were absent in surrounding healthy tissue and around ducts of in situ component (with 5% do 100%. The threshold of 30% of peritumoral clefts was determined by receiver operating characteristic (ROC) analysis. The density of small lymphatic vessels in the stroma of the tumor, and outside the tumor tissue did not show signifi cant correlation with the threshold value. In patients with axillary metastases, peritumoral lymphovascular invasion (LVI) was found twice and intratumoral LVI fi ve times more often than in patients without axillary metastases. Neither peritumoral nor intratumoral LVI were signifi cantly correlated with the threshold value of 30%. In patients with axillary lymph node metasases, peritumoral lymphovascular invasion (LVI) was found twice as often, and intratumoral LVI 5 times as often than in patients without axillary lymph node metastases. Conclusion: Peritumoral clefts in invasive breast carcinoma refl ect stromal changes of fi broblasts and are not associated with lymphangiogenesis, that is probably caused by some other pathogenesis.

The Prognostic Value of Retraction Clefts in Chinese Invasive Breast Cancer Patients

“…In the Japanese study [12], this ratio was 52.8% which was close to Acs' results. Kos and Leniček even reported 92% occurrence ratio of RCs in their study based on Croatian [23]. Thus, we examined our sample selection and processing procedures from fixation to embedding, sectioning and staining, and compared the occurrence of RCs in the samples from different years (from 2010 to 2017) to identify the possible reason for our lower ratio of RCs.…”

“…However, these results were opposite to previous investigations [4-6, 9, 15] reporting that the extensive RCs were linked to poor prognosis in lymph node positive invasive breast carcinoma. Meanwhile, Kos and Leniček found no relationship between RCs and lymph node metastases [23]. Therefore, the prognostic value of RCs was still of doubt, more researches on larger study populations are needed to get more certain conclusions.…”

“…A few more studies from University of Maryland Medical Center in the United States, Osaka National Hospital in Japan and the Fourth Hospital of Hebei Medical University in China also provided evidence to support this idea [10,12,15]. In contrast, except for the explanation of RCs as tissue shrinkage caused by handling and fixation [18][19][20][21][22], Kos and Leniček believed no association between lymphangiogenesis and RCs in the patients from University Hospital in Zagreb, Croatia [23]. Therefore, it is important to analyze RCs' clinical value in more patients from different population in larger areas.…”