TUMOR OXYGENATION CORRELATES WITH MOLECULAR GROWTH DETERMINANTS IN BREAST-CANCER

Hypoxic tumor cells may represent a fraction of cells that are not sus ceptible to radiation or chemotherapy. Intratumoral oxygen partial pre ssure (pO(2)) is the result of oxygen delivery and consumption. Cell p roliferation is one factor to effect oxygen consumption and we therefo re studied the correlation between tumor pO(2) and histological parame ters. Patients and methods: In 36 women and one man (age range 29-80 y ears) with suspected breast cancer. Before tumor resection, intralesio nal pO(2) was determined with a polarographic needle electrode. Under ultrasound control, 200 tumor measurements were obtained; Hb levels, H k, arterial blood gas parameters, and tissue temperature were determin ed. The median of pO(2) values and the percentage of hypoxic areas (pO (2) < 10 mmHg) were calculated and correlated with the histological ty pe, grading, ER, PR, and the expression of Ki-67, p53, EGFR, pS2, and c-erb-B2. Results: The overall median pO(2) was 44 mmHg, and 1024 meas urements (13.8%) represented hypoxic areas. Ductal and lobular invasiv e cancers showed median pO(2) of 41 mmHg. The mean pO(2) of G1 tumors was 59 mmHg and the hypoxic fraction 8%, in contrast to G2 tumors with 43 mmHg and 17%, and G3 tumors with 36 mmHg and 20.4% (p < 0.01). We observed a correlation with tumor size and an increased rate of hypoxi c areas in T3-4 lesions (p < 0.02). Also tumors with negative nodes or positive ER had significantly higher pO(2) values, as did tumors with an overexpression of c-erb-B2, p53, and cathepsin D. Conclusion: Oxyg enation of human breast cancers can safely be measured in patients pri or to surgical therapy, pO(2) values correlate both with prognostic ma rkers examined histologically and with molecular growth factors. As th e efficacy of preoperative or adjuvant treatment in individuals may de pend on oxygen partial pressure, efforts to manipulate tumor pO(2) for therapeutic purpose could be promising.