[Inspection on angiogenesis in malignant transformation of breast tumor by ultrasound contrast and quantitative analysis].

ABSTRACT

OBJECTIVE: To study the effects of angiogenesis on tumorigenesis and the progression of breast carcinoma and precancerous lesion. METHODS: Real time ultrasound contrast enhanced microvascular imaging (MVI) and time-intensity curve quantitative analysis were conducted on 30 normal controls, 30 cases with simple hyperplasia, 30 cases with atypical hyperplasia (AH), 20 cases with intraductal carcinoma in situ, and 50 cases with invasive ductal carcinoma, all female. Specimens of breast tissues were obtained and immunohistochemistry was used to detect the expression of CD34, a marker of vascular endothelial cells, and vascular endothelial growth factor (VEGF) and its receptor Flk-1/KDR. RESULTS: With the progression of malignant transformation of breast tissue, the expression levels of VEGF and Flk-1/KDR increased gradually, the framework of the vessels became disordered, the levels of MVD and the perfusion parameters, such as peak intensity (PI), area under the curve (AUC), and wash-out time (WOT), increased. Obvious changes in these parameters began since the AH stage. There were not significant differences in the PI, AUC, and WOT levels between the groups of AH and in situ cancer, however, the VEGF and Flk-1/KDR levels of the in situ carcinoma group were significantly higher than those of the AH group (both P<0.05). CONCLUSION: Angiogenesis plays an important role in the development of breast carcinoma. Contrast MVI and the main perfusion parameters reflect the rule of angiogenesis activity changing in different precancerous lesions, and can be used as non-invasive methods to screen high risk population.