Evaluation of lymphovascular invasion and lymph node involvement by imunohistochemistry staining in breast carcinoma

Introduction & Aim: Breast Carcinoma is the most common malignant tumor and the leading cause of carcinoma death in women, affects Iranian women at least one decade earlier. Lymphatic invasion and lymph node metastasis are the most important prognostic parameters in breast carcinoma. The aim of this study was the assessment of lymphatic vessel invasion and the site of invasion by D2-40 staining and also evaluation of lymph nodes metastasis by cytokeration staining. METHODS: 116 malignant breast tumor during March, 2010 to June 2014 were evaluated. D2- 40 staining on breast paraffin blocks for assessment of lymphatic invasion and cytokeration staining on lymph nodes paraffin blocks to evaluation of micrometastasis or isolated tumoral cell were done. RESULTS: Sensitivity, specificity, positive and negative perdictive values of H&E staining for detection of lymphatic invasion were 41%, 66%, 54.8% and 53.5% respectively. Kappa coefficient for H& E and D2-40 staining was 0.078. The most common sites of lymphatic invasion were intratumoral area and tumor periphery. Cytokeratin staining was positive in 6(33.3%) of 18 negative lymph nodes ( P= 0.0001). CONCLUSIONS: According to these results it seems that D2-40 staining is necessary for accurate diagnosis of lymphatic invasion. Also evaluation of intratumoral area and tumor periphery is probably increased the chance of finding lymphatic invasion. Cytokeratin staining is suggested to finding micrometastasis or isolated tumoral cells in negative lymph nodes.

کلیدواژه ها:

Breast carcinoma ، Lymphatic invasion ، lymph node metastasis ، D2-40 ، Cytokeratin