血清HER-2／neu胞外域在复发转移性乳腺癌患者解救化疗中的临床意义  

The clinic significance of the HER-2/neu ECD in patients with recurrent and metastatic breast cancer receiving salvage chemotherapy

作　　者：刘春萍[1] 逯翀[1] 田元[2] 黄韬[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院乳腺甲状腺外科,武汉430022 [2]华中科技大学同济医学院普外科实验室

出　　处：《中华实验外科杂志》2009年第4期422-424,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨血清HER-2／neu胞外域（ECD）在复发转移性乳腺癌患者解救化疗中的临床意义。方法酶联免疫吸附试验检测健康志愿者、良性乳腺疾病患者各27例的血清HER-2／neuECD水平及27例复发转移性乳腺癌患者化疗前后的血清HER-2／neuECD水平，结合其临床资料进行统计学分析。结果健康志愿者与乳腺良性疾病患者血清HER-2／neuECD水平均低于15μg/L，差异无统计学意义（P〉0．05）；复发转移性乳腺癌患者化疗前血清HER-2／neuECD的平均浓度为（47．30±109．06）μg/L，显著高于健康志愿者及乳腺良性疾病患者（P〈0．01）。血清HER-2／neuECD水平与原发肿瘤HER-2／neu的表达成正相关（r=0．752，P〈0．01）。解救化疗有效的患者，化疗3周后血清HER-2／neuECD水平较化疗前明显降低（P〈0．05），化疗3周后与化疗6周后血清HER-2／neuECD水平差异无统计学意义（P〉0．05）。化疗前HER-2／neuECD水平与患者总生存期呈负相关（r=-0．601，P〈0．01），而与无进展生存期无明显相关（r=-0．374，P〉0．05）。化疗前血清HER-2／neuECD〉15μg／L与HER-2／neuECD〈15μg／L的患者比较，总生存率前者低于后者（P〈0．05），无进展生存率两者间差异无统计学意义（P〉0．05）。结论血清HER-2／neuECD水平的监测，有助于早期发现乳腺癌的复发转移，指导解救化疗方案的选择，评估患者的疗效及预后。Objective To investigate the clinical significance of the extracellular domain （ECD） of the HER-2/neu receptor in serum in patients with recurrent and metastatic breast cancer receiving salvage chemotherapy. Methods HER-2/neu ECD in sera obtained from 27 healthy volunteers,27 patients with benign breast disease, and 27 patients with recurrent and metastatic breast cancer around chemotherapy was measured by ELISA,and statistically analyzed in combination with clinical data. Results There was no significant difference in HER-2/neu ECD levels （below 15μg/L） between healthy volunteers and patients with benign breast disease （P〉 0.05 ）. The mean concentration of HER-2/neu ECD in patients with recurrent and metastatic breast cancer before salvage chemotherapy was （47.30 ±109.06） μg/L. As compared with healthy volunteers and patients with benign breast disease, patients with recurrent and metastatic breast cancer had significantly higher levels of HER-2/neu ECD （ P 〈 0.01 ）. There was a significant correlation between HER-2/neu expression in primary tumor detected by immunohistochemistry and HER-2/neu ECD detected by ELISA （r =0. 752,P 〈0.01 ）. A decrease in HER-2/neu ECD levels from baseline was found at week 3 in patients response for salvage chemotherapy （P 〈0.05） ,which was similar to that at week 6 （P 〉 0.05）. The HER-2/neu ECD levels before chemotherapy had a negative correlation with overall survival （ r = - 0. 601,P 〈 0.01 ）, but had no correlation with progression free survival （ r = - 0. 374,P 〉 0.05 ）. As compared with patients with baseline below 15 μg/L,patients with initially elevated HER-2/neu ECD levels （ 〉 15 Ixg/L） had lower overall survival rate （P 〈0.05） and similar progression free survival （P 〉0.05）. Conclusion The monitoring of HER-2/neu ECD levels is helpful to detect recurrence and metastasis of breast cancer, select regimen of salvage chemotherapy as well as evaluate the efficacy and prognosis.

关 键 词：乳腺肿瘤 血清 治疗 

分 类 号：R737.9[医药卫生—肿瘤] R737.905[医药卫生—临床医学]