循环血肿瘤细胞在预测转移性乳腺癌化疗疗效中的应用  

Application of circulating tumor cells on predicting treatment outcome of chemotherapy in metastatic breast cancer

作　　者：郑建[1] 李丽[1] 

机构地区：[1]大连医科大学附属第一医院肿瘤科,辽宁大连116011

出　　处：《中华肿瘤防治杂志》2009年第3期193-196,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：辽宁省自然科学基金(20052166)

摘　　要：目的：探讨循环血肿瘤细胞（circulat-ing tumor cells,CTC）数目对转移性乳腺癌化疗疗效的评价作用。方法：分离循环血单核细胞,应用免疫磁珠富集-免疫荧光细胞化学（IME-FICC）方法,检测30例转移性乳腺癌患者化疗1周期前后和10例乳腺良性疾病患者循环血肿瘤细胞数目。结果：30例转移性乳腺癌患者化疗前循环血中有21例检测到CK8/18^＋细胞,阳性率为70.0%,10例乳腺良性疾病患者循环血中均未检测到CK8/18^＋细胞,该方法的特异性为100.0%,χ^2=12.06,P〈0.05。30例转移性乳腺癌患者化疗1周期后循环血肿瘤细胞数目上升13例（43.3%）,不变8例（26.7%）,下降9例（30.0%）;影像学评价疗效,进展15例（50.0%）,无变化8例（26.7%）,缓解7例（23.3%）,两组间差异无统计学意义（t=0.67,P〉0.05）。结论：应用IME-FICC方法,依据循环血肿瘤细胞数目可以判定转移性乳腺癌化疗疗效,较目前常规的基于影像学结果判定疗效早3-4周。OBJECTIVE： To explore the feasibility of using the number of circulating tumor cells（CTC） to evaluate curative effect of chemotherapy in metastatic breast cancer. METHODS： The number of CTC in thirty metastatic breast cancer patients before and after one chemotherapy cycle respectively and ten nonmalignant mammary gland patients were detected by IME-FICC after separating the peripheral blood mononuclear. RESULTS： The positive rate of CK8/18^＋ in thirty metastatic breast cancer patients was 70.0%,and none of CK8/18^＋ could be detected in ten nonmalignant mammary gland patients, with a specificity of 100.0%（χ^2 =12.06, P〈0.05）. The number of CTC in thirty metastatic breast cancer patients increasesd in 13 cases （43.3%）, unchanged in 8 cases （26.7%） and descented in 9 cases （30.0%） respectively after one chemotherapy cycle, however, 15 cases（50.0%） were PD, 8 cases（26.7%） were NC and 7 cases（23.3%） were RR by imaging respectively, t=0.67, P〉0.05. CONCLUSION： The application of circulating tumor cells on predicting effects of chemotherapy in metastatic breast cancer is feasible by IME-FICC,and comparing with imaging as early as 3--4 weeks.

关 键 词：乳腺肿瘤 外周血 肿瘤细胞 免疫磁珠富集 免疫组织化学 疗效 

分 类 号：R737.9[医药卫生—肿瘤]