Prognostic Significance of Microvessel Density in Breast Cancer of Thai Women
Siroj Kanjanapanjapol MD*, Sansanee Wongwaisayawan MD**, Samart Phuwapraisirisan MD*, Chumpon Wilasrusmee MD, MSc*
Affiliation : * Department of Surgery, Ramathibodi Hospital **Department of Pathology, Ramathibodi Hospital
Objective : Angiogenesis is important in the process of tumor growth and progression of breast cancer.
Microvessel density (MVD) is the most commonly used technique to quantify intratumoral angiogenesis in
breast cancer. In the present study, the authors investigated the prognostic indicator of intratumoral MVD in
predicting overall survival, disease recurrence, and distance metastasis of breast cancer.
Materials and Methods : Two hundred patients who were diagnosed as invasive breast cancer from January
2000 to December 2004 were included in the present study, but only 64 patients had complete pathological
specimens and tumor receptor studies. Representative paraffin sections of the primary tumor including the
tumor border were immunostained with a monoclonal anti-CD34 antibody. The area of highest vascular
density (“hot spot”) was identified and the average count of three hot spots in each tumor was used for
analyses. The distribution of MVD was categorized into high and low MVD as more than 76 and less than 76
respectively. Overall survival probability was estimated by the Kaplan-Meier method. A multivariate Cox
regression was employed to examine the relationship between MVD and disease outcomes while adjusting for
other concomitant variables.
Result: The tumor size and more advanced disease have correlated with poor outcomes of invasive breast
cancer. Tumor size is a poor predictor for local recurrence [Harzard ratio1.02 (95%CI 0.99-1.04)] and more
disease staging have correlated with distance metastases [Harzard ratio1.48 (95%CI 0.98-2.24)]. The cancer
staging only predicted poor outcome in invasive breast cancer in overall recurrence [Harzard ratio1.51
(95%CI 1.05-2.16)]. MVD is not correlated with both tumor recurrence and distance metastases [Hazard
ratio for local recurrence1.01 (95%CI 0.99-1.04) and Harzard ratio 1.00 (95%CI 0.97-1.02)].
Conclusion : The microvessel density (MVD) has not predicted poor outcomes of invasive breast cancer in
Thai woman.
Keywords : Angiogenesis, Anti-CD34, Survival
