CORRELATION OF PROLIFERATIVE ACTIVITY AND MICROVESSEL DENSITY OF THE TUMOUR WITH STANDARD PROGNOSTIC MARKERS IN INVASIVE BREAST CARCINOMA
GÜNAY GÜRLEYİK, DİLEK KÜÇÜKERCAN, GÜLDEREN DEMİREL, EMİN GÜRLEYİK, ÖNDER PEKER, ABDULLAH SAĞLAM
Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İSTANBUL
Observation of significant dissemination and recurrence rate even in breast cancer patients evaluated as low risk according to standard prognostic markers suggests influence of other factors effective on clinical course and overall prognosis. Therefore it is emphasized importance of tumour's proliferative activity and metastatic ability in addition to classical parameters. In this study we aimed to analyze correlation of tumour's proliferative activity and microvessel density with standard prognostic markers in patients with invasive breast cancer. Classical parameters as age, size and histologic grade of the tumour, and axilla nodal status were determined in 17 surgically treated patients with stage I and IIA invasive breast carcinoma. Proliferative activity (DNA ploidy and S phase fraction) of the tumours was measured by flow cytometry. Tumour's microvessel density (angiogenesis) was also determined as a marker of metastatic ability. We found T2tumours in 12 (71 %), grade 2 and 3 tumours in 12 (71%), and axilla node positive status in 9 (53%) patients. Angiogenesis levels were significantly higher (p<0.05) in larger (T2) tumours. S phase fraction (p<0.05) and angiogenesis (p<0.05) were significantly increased in patients with axillary metastasis (node positive). Higher S phase fraction levels were found in aneuploid tumours. High S phase and angiogenesis levels, and aneuploidy was observed respectively in 25%, 38%, and 38% of axillary node negative patients. Tumours with high proliferative activity and metastatic ability may exist even in patients with no axillary involvement. Tumour's DNA ploidy and S phase fraction by flow cytometry, and tumour's microvessel density (angiogenesis) are useful markers to evaluate true risk, overall prognosis, and to plan adjuvant treatment in patients which was evaluated as low risk according to standard prognostic markers.
Keywords: BREAST CANCER, AXILLA, FLOW CYTOMETRY, DNA PLOIDY, S PHASE, ANGIOGENESIS