Breast Cancer Research and Treatment

, Volume 36, Issue 2, pp 205–217

Prognostic value of intratumoral microvessel density, a measure of tumor angiogenesis, in node-negative breast carcinoma — results of a multiparametric study

  • Pierantonio Bevilacqua
  • Mattia Barbareschi
  • Paolo Verderio
  • Patrizia Boracchi
  • Orazio Caffo
  • Paolo Dalla Palma
  • Salvatore Meli
  • Noel Weidner
  • Giampietro Gasparini
Article

Summary

In the present study we update previous results on the prognostic value of intratumoral microvessel density (IMD), determined immunocytochemically using the monoclonal antibody CD-31 and a standard streptavidin-immunoperoxidase technique, published in theJ Clin Oncol 12:454–466, 1994. This study was undertaken in those 211 node-negative breast cancer (NNBC) cases of that series of which we had pathological material available to determine all the prognostic indicators. The median period of follow-up has been extended to 78 and 80 months for relapse-free survival (RFS) and overall survival (OS), respectively, and new biological indicators (i.e. Ki-67 labeling and 67 kDa laminin receptor expression) were included in the analysis.

The main results obtained are:i) a confirmation that IMD is not associated with the other biological markers studied, i.e. expression of p53 protein, c-erbB-2 protein, 67 kDa laminin receptor, and cell kinetics; IMD was weakly associated only with histological grade (p=0.053);ii) IMD remains a highly significant prognostic factor for RFS and OS (p<0.0001 and p=0.018, respectively) in univariate analysis;iii) in multivariate analysis on RFS, IMD (likelihood ratio test (LRT)=30.16; p<0.0001), 67 kDa laminin receptor (LRT=9.80; p=0.0017), the IMD/67 kDa laminin receptor interaction (LRT=8.62; p=0.0033), tumor size (LRT=8.56; p=0.0034), and p53 protein (LRT=4.96; p=0.025) are significant and independent prognostic indicators. For OS, only tumor size (LRT=8.34; p=0.0038), menopausal status (LRT=5.16; p=0.023), p53 protein (LRT=4.37; p=0.036), and IMD (LRT=4.05; p=0.044) retain a significant and independent prognostic value.

The results of this study confirm the prognostic importance on RFS of the variables previously tested, but not of peritumoral lymphatic vessel invasion. A novel finding is that 67 kDa laminin receptor and the IMD/67 kDa laminin receptor interaction are also significant and independent variables. For OS, the results confirm that both IMD and tumor size are significant and independent variables. With prolonged follow-up the novel finding that emerges is the prognostic importance of menopausal status and p53 protein.

This new information could be useful for a more accurate selection of high-risk NNBC patients who require careful follow-up and may benefit from adjuvant therapy.

Key words

c-erbB-2 protein histologic grade Ki-67 laminin receptor multivariate analysis node-negative breast cancer p53 peritumoral lymphatic vessel invasion prognosis tumor angiogenesis 

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Copyright information

© Kluwer Academic Publishers 1995

Authors and Affiliations

  • Pierantonio Bevilacqua
    • 1
  • Mattia Barbareschi
    • 2
  • Paolo Verderio
    • 3
  • Patrizia Boracchi
    • 3
  • Orazio Caffo
    • 2
  • Paolo Dalla Palma
    • 2
  • Salvatore Meli
    • 1
  • Noel Weidner
    • 4
  • Giampietro Gasparini
    • 1
  1. 1.Department of OncologySt. Bortolo Regional Medical CenterVicenzaItaly
  2. 2.St. Chiara Regional Medical CenterTrentoItaly
  3. 3.Institute of Medical Statistics and BiometryUniversity of MilanItaly
  4. 4.Dept. of PathologyUniversity of CaliforniaSan FranciscoUSA

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