Microvessel density quantification in breast carcinomas. Assessment by light microscopy vs. a computer-aided image analysis system

M. Barbareschi, N. Weidner, G. Gasparini, L. Morelli, S. Forti, C. Eccher, P. Fina, O. Caffo, E. Leonardi, F. Mauri, P. Bevilacqua, P. Dalla Palma

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Intratumoral microvessel density (iMVD) has been reported as an independent prognosticator for breast carcinoma patients. iMVD should be measured in areas of highest neovascularization ('hot spots'). Yet, measuring iMVD in the hot spot yields good, albeit variable, results due to subjectivity in identifying the hot spot. The aim of this study was to compare iMVD determinations by light microscopy (LM) between two pathologists of different experience and by a computer-aided image analysis system (CIAS). Also, CIAS determined the total microvessel area (MVA) and the total microvessel perimeter (MVP) within the same field. Microvessels from 91 node-negative, invasive ductal breast carcinomas were highlighted with anti-CD31. Median patient follow-up was 66.3 months (range 3-99). Because of limited deaths from carcinoma, survival analysis was restricted to relapse-free survival (RFS). LM-measured iMVDs correlated between pathologists (p = 0.0001) but with moderate variability (r2 = 0.4). Also, LM-measured iMVDs correlated with MVA (p = 0.0003) and MVP (p = 0.0001). By univariate analysis, the LM-measured iMVD determined by the experienced pathologist (p = 0.002), MVA (p = 0.009), MVP (p = 0.032), and tumor diameter (p = 0.005) were associated with RFS. Multivariate analysis revealed that tumor diameter (p = 0.0016), LM-measured iMVD by the experienced pathologist (p = 0.0062), and MVA (p = 0.0445) were independently associated with RFS. For inexperienced pathologists, computer-aided iMVD measurement, which measures not only iMVD but also MVA and MVP, may be a more objective way to quantify the angiogenic activity of tumors.

Original languageEnglish
Pages (from-to)75-84
Number of pages10
JournalApplied Immunohistochemistry
Issue number2
Publication statusPublished - 1995


  • angiogenesis
  • blood vessel
  • breast carcinoma
  • computer
  • prognosis
  • survival

ASJC Scopus subject areas

  • Anatomy
  • Medical Laboratory Technology


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