The role of angiogenesis, laminin and CD44 expression in metastatic behavior of early-stage low-grade invasive breast carcinomas
Review articleOpen access

AbstractTo investigate the role of tumor angiogenesis, laminin and CD44 expression in metastatic potential of breast cancers, 35 early-stage (T1) and/or low-grade (grade 1) invasive breast carcinomas including 18 metastasizing and 17 non-metastasizing cases were analyzed in the present study. Angiogenesis was assessed by a stereologic method after immunohistochemical staining of vascular endothelium for factor VIII. The quantification of the tumor vascularization was based on the vascular surface density (VSD) and the microvessel number (NVES). The expressions of laminin and CD44 were evaluated by scoring the intensity and distribution of the immunostaining. The assessment of NVES and VSD resulted in a statistically significant difference between the two groups (P<0.05, independent-samples t-test). In the breast cancers with metastatic spread, NVES was found to be 16.0±2.9 mm−2 whereas it was 8.1±0.7 mm−2 in the metastasizing group. VSD was found to be 59.0±12.6 mm−1 in the metastasizing group and was significantly lower in the non-metastasizing group (33.8±2.6 mm−1). Immunohistochemistry exhibited strongly positive staining for CD44 in 22% of the breast cancers with metastasis, while 65% of the non-metastasizing cases were found to be negative. The statistical analysis also resulted in a significant difference (P=0.034, χ2 test). However, the immunohistochemical staining for laminin did not yield any significant difference (P=0.347, χ2 test). Approximately half of the cases being either metastasizing or non-metastasizing stained weakly positive for laminin. We concluded that angiogenesis and CD44 expression in breast cancers correlated significantly with lymph node or distant metastasis. However, the immunodetection of laminin expression in our study did not help to evaluate its role in the metastatic potential of breast cancers. We concluded that vascular parameters, such as an increase in microvessel number, and CD44 expression might be useful prognostic indicators of metastasis in breast cancer.

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