The prognostic value of angiogenic activity evaluation with contrast enhanced power doppler imaging in axillary-node-negative breast carcinoma

Abstract

To determine the value of contrast ultrasound on evaluating tumor angiogenic activity and its prognostic value in axillary-node-negative breast carcinoma (ANNBC). Power doppler imaging (PDI) was used to observe intratumoral vascularization before and post contrast agents injection. Intratumoral blood flow signals were measured and intratumoral vessel positive total areas (VPTA) were analyzed with computer-assisted quantitative assessment. Sections of malignant tumors were analyzed for the intratumoral microvessel density (MVD) by immunohistochemistry using monoclonal antibody to factor VIII-related antigen. The relationships within VPTA, MVD and prognosis were the main outcome measures. There was no significant correlation between VPTA and MVD before contrast agents used while there was a positive correlation between them after that. However, VPTA and MVD had significant correlation with histology grade and tumor recurrence and metastasis while had no correlation with the general clinic pathologic factors. VPTA and MVD were significantly higher in postoperative cases with recurrence or metastasis than those in cases with tumor-free. Total survival rate and tumor-free survival rate of high-VPTA or high-MVD group were significantly lower than those of low-VPTA or low-MVD group. The value of VPTA by contrast enhanced PDI was a beneficial prognostic indicator. High VPTA in ANNBC patients may has worse prognosis and antiangiogenic therapy is strongly suggested on them.