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The correlation between TAM, MVD, VEGF and MMP-9 expressions among various histological progression, histological grading and staging of breast cancer
Breast cancer may progress from an atypical lesion. Angiogenesis has an important role in the growth, invasion and metastasis of breast cancer, which can be reflected through the microvascular density (MVD). Tumor associated macrophages (TAMs) are stromal cells that can produce pro-angiogenic factor su ch as vascular endothelial growth factor (VEGF), and induce matrix metalloproteinase-9 (MMP-9) for degrading extracellular matrix and basement membrane. Angiogenesis in breast cancer progression and its relationship with histological grading as well as its staging need to be defined and thus, cancer therapy and prognosis can be determined more accurately. The aim of this study was to investigate the correlation between TAM, MVD, VEGF and MMP-9 expressions among fibrocystic lesion, atypical lesion and breast cancer, and its correlation with histological grading and staging of breast cancer. Using across-sectional study, a total of 50 paraffin embedded tissues of fibrocystic lesion, atypical lesion and breast cancer were chosen in this study. Those specimens were stained immunohistochemically with monoclonal anti body (MoAb) anti CD68, von Willebrand factor (vWF), VEGF and MMP-9. The expressions of VEGF and MMP-9 were counted from the mean numbers of positive tumor cells. TAMs were counted from num,bers of macrophages which expressed CD-68. MVDs were counted from numbers of rnlcrovessbls whose endothelial cells expressed vWF, using the Average Microvessels Count ( AMC) method. The correlation of both markers and different type of breast lesions ~re analyzed by using Pearson correlation. There were statistically significant correlations between TAM (r=0.760; p=0.000), MVD (r=0.659; p =0.000), and MMP-9 (r=0.518; p =0.000), among several breast lesions and histological grade of breast cancer. The highest of their expressions was found in the poor grade of cancers. There were statistically significant correlations between TAM (r=0.581; p=0.000), VEGF (r=0.443; p=0.001) and MVD (r=0.566; p=0.000) among fibrocystic, atypical lesion and stage II - III of breast cancer. VEGF expression was not significantly correlated with several histological grade of breast cancer and the highest of its expression was only found in atypical lesion. This study has suggested that TAM, MVD, VEGF and MMP-9 expressions might play an important role in the histological progression, histological grading and staging of breast cancer. The highest expression of VEGF in atypical breast lesion supported the fact that angiogenic switch already started in the early stage and grade of breast cancer.
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