Prognosis of Metastasis of Ductal Carcinoma by Using Immunohistochemical Researches

Ductal carcinoma ranks first in the structure of women's mortality from oncological diseases. Every year in Ukraine more than 13 thousand new cases are registered (up to 17,500 by 2014 for unspecified data). The literature contains references to the prediction of metastases using morphometric parameters (tumor size, number of alveolar structures). For predictive purposes, the definition of the odds ratio and relative risk is widely used. These figures refer to the section of evidence-based medicine. The purpose of the study was to determine the relative risk and relationship of the chances of ductal carcinoma metastatic process on the basis of the criteria for each of the applied immunohistochemical methods (vimentin, von Willebrand factor, metalloproteinase-2 and 9). Materials and methods. The research used data of 162 protocols of ductal carcinoma. All cases were divided into two groups: a group with lymphogenous metastases (n = 97) and without them (n = 65). All patients underwent immunohistochemical examinations of the surgical material of the breast with primary antibodies against antigens: vimentin, von Willebrand factor, metalloproteinase-2 and 9 (polymeric system of visualization with diaminobenzidine - DAKO). The method of selection of the best values was determined by quantitative criteria for prediction of tumor metastases by each individual method of immunohistochemical research. Results and discussion. The calculation results of the magnitude of prognostic indicators are ranked by relative risk (Risk Ratio). Concerning the determination of vimentin, the relative risk value is 6.37, the odds ratio is 40.53 with a specificity of 78.46% and a sensitivity of 91.75%. As to the matrix metalloproteinase-2, the relative risk is 4.37, the odds ratio is 16.70 with a specificity of 63.08% and a sensitivity of 90.72%. As to the matrix metalloproteinase-9, the relative risk is 2.59, the odds ratio is 9.63 with a specificity of 73.85% and a sensitivity of 77.32%. As to the factor von Willebrand, the relative risk is 2.65, the odds ratio is 9.32 with a specificity of 70.77% and a sensitivity of 79.38%. Conclusions. According to the results of the research, the highest individual metastases' prediction of ductal carcinoma revealed during an immunohistochemical investigations of antigens to vimentin. The lowest prognosis for relative risk and odds ratio was obtained in determining matrix metalloproteinase-9.