POVEZANOST POJAVE PERITUMORALNIH PUKOTINA U DUKTALNOM INVAZIVNOM KARCINOMU DOJKE S MIOFIBROBLASTIČNOM REAKCIJOM STROME

Tanja Leniček, Marina Kos

Cilj: Utvrditi postoji li povezanost između peritumoralnih pukotina i miofibroblastične reakcije strome u duktalnim invazivnim karcinomima dojke bez posebnih obilježja. Metode: U 100 invazivnih duktalnih karcinoma dojke u žena analizirani su postojanje peritumoralnih pukotina i imunohistokemijska izraženost CD34, vimentina i glatkomišićnog aktina (SMA) u tumorskoj stromi. Rezultati: Peritumoralne pukotine nađene su u 92% karcinoma, dok u okolnom tkivu i oko žarišta duktalnog karcinoma in situ nisu nađene. Proširenost pukotina bila je 5 do 100%. Apsolutni postotak peritumoralnih pukotina bio je znatno povezan s količinom SMA+ miofibroblasta u stromi, veličinom tumora i pT-stadijem bolesti, prisutnošću metastaza u aksilarnim limfnim čvorovima i udjelom pozitivnih limfnih čvorova. Tumori s opsežno izraženim peritumoralnim pukotinama (u > 30% tumora) imali su znatno veću količinu SMA+ miofibroblasta u stromi, češće metastaze u aksilarne limfne čvorove i veći udio pozitivnih limfnih čvorova. Zaključak: Peritumoralne pukotine morfološki su izraz promijenjenih osobina tumorske strome u obliku zadobivanja miofibroblastičnog fenotipa.

Aim: To determine the correlation of peritumoral retraction clefts and myofibroblastic stromal reaction in invasive breast carcinomas of no special type. Methods: Peritumoral clefts were analyzed in 100 invasive ductal breast carcinomas. Stromal reaction was analyzed immunohistochemically with CD34, vimentin and smooth muscle actin (SMA). Results: Peritumoral clefts were found in 92% of invasive carcinoma tissue and were absent in surrounding normal tissue and around ducts of in situ component. The extent of peritumoral clefts ranged from 5% to 100% and correlated significantly with the quantity of SMA+ stromal myofibroblasts, increased tumor size, pT stage, presence of lymph node metastasis and the rate of positive lymph nodes. Extensive peritumoral clefts (in >30% of tumor tissue) correlated significantly with higher quantity of SMA+ myofibroblasts, higher frequency of lymph node metastases and higher rate of positive lymph nodes. Conclusion: Peritumoral retraction clefts are morphological expression of the phenotypic changes of tumor stromal cell that acquire myofibroblastic characteristics.