Changes in the metabolism of axillary lymph node cells as a predictor of regional metastasis in breast cancer

Figure 1 Study design flowchart. DLE: Delayed luminescence of erythrosine; CXCR4: C-X-C motif chemokine receptor 4; VCAM-1: Vascular cell adhesion molecule-1.

Figure 2 Kinetics of delayed fluorescence in a lymph node stained with erythrosine. A: Kinetics of delayed fluorescence in a lymph node stained with erythrosine under multi-pulse excitation at a frequency of 10 Hz (curves for the first and tenth excitation pulses are shown); B: Kinetics of phosphorescence in a lymph node stained with erythrosine under multi-pulse excitation at a frequency of 10 Hz (curves for the first and tenth excitation pulses are shown); C: Change in the integral intensity of singlet oxygen-sensitized delayed fluorescence (SOSDF) of erythrosine in stained tissue during 10-pulse excitation (the integral intensity of SOSDF for the first pulse is taken as unity). SOSDF: Singlet oxygen-sensitized delayed fluorescence; DLE: Delayed luminescence of erythrosine.

Figure 3 Examples of Vascular cell adhesion molecule-1 and C-X-C motif chemokine receptor 4 expression assessment in an axillary lymph node. A: Assessment of the number of sinuses (2: > 15%) and lymphoid follicles (1: ≥ 5% and < 30% of the lymph node area) in the axillary lymph node; B: Assessment of vascular cell adhesion molecule-1 (VCAM-1) expression in the lymph node sinuses (0: No expression), lymph node follicles (0: No expression), lymph node cortex (0: No expression) and lymph node medulla (0: No expression); C: Assessment of C-X-C motif chemokine receptor 4 (CXCR4) expression in the lymph node sinuses (1: Weak expression), lymph node follicles (2: Moderate expression), lymph node cortex (1: Weak expression), and lymph node medulla (1: Weak expression); D: Breast cancer metastasis in the axillary lymph node (arrow); E: No VCAM-1 expression in tumor cells in the lymph node with metastasis; F: Weak CXCR4 expression in tumor cells in the lymph node with metastasis (A and D: Mayer’s hematoxylin and eosin staining; B and E: Staining with antibodies against VCAM-1; C and F: Staining with antibodies against CXCR4).

Figure 4 Values of the delayed luminescence of erythrosine depending on the nature of the changes in the axillary lymph nodes.

Figure 5 Vascular cell adhesion molecule-1 expression scores according to the nature of the changes in axillary lymph nodes. VCAM-1: Vascular cell adhesion molecule-1; LN: Lymph node.

Figure 6 C-X-C motif chemokine receptor 4 expression scores depending on the nature of the changes in axillary lymph nodes. CXCR4: C-X-C motif chemokine receptor 4; LN: Lymph node.

Figure 7 Heatmaps of correlations between indicators of delayed luminescence of erythrosine and clinical and pathological characteristics of patients with breast cancer. +: Positive correlations; -: Negative correlations; BC: Breast cancer; ER: Estrogen receptor; HER2: Human epidermal growth factor receptor 2; IDC: Intraductal component; LVI: Lymphovascular invasion; PNI: Perineural invasion; PR: Progesterone receptor.

Figure 8 Heatmaps of correlations between vascular cell adhesion molecule-1 expression in axillary lymph nodes and clinical and pathological characteristics of patients with breast cancer. VCAM: Vascular cell adhesion molecule; +: Positive correlations; -: Negative correlations; BC: Breast cancer; ER: Estrogen receptor; HER2: Human epidermal growth factor receptor 2; IDC: Intraductal component; LN: Lymph node; LVI: Lymphovascular invasion; PNI: Perineural invasion; PR: Progesterone receptor.

Figure 9 Heatmaps of correlations between C-X-C motif chemokine receptor 4 expression in axillary lymph nodes and clinical and pathological characteristics of patients with breast cancer. +: Positive correlations; -: Negative correlations; CXCR4: C-X-C motif chemokine receptor 4; BC: Breast cancer; ER: Estrogen receptor; HER2: Human epidermal growth factor receptor 2; IDC: Intraductal component; LN: Lymph node; LVI: Lymphovascular invasion; PNI: Perineural invasion; PR: Progesterone receptor.

Figure 10  Correlations between the studied markers. +: Positive correlations; -: Negative correlations; CXCR4: C-X-C motif chemokine receptor 4; LN: Lymph node; VCAM: Vascular cell adhesion molecule-1.