乳腺癌分子分型与外周血循环肿瘤细胞相关性探讨  

Correlation between molecular subtypes and circulating tumor cells in breast cancer

作　　者：李世超[1] 姜军[1] 杨新华[1] 张毅[1] 范林军[1] 张帆[1] 刘静[1] 孙鹏[1] 王明浩[1] 

机构地区：[1]第三军医大学西南医院乳腺疾病中心,重庆400038

出　　处：《第三军医大学学报》2012年第10期1006-1010,共5页Journal of Third Military Medical University

摘　　要：目的探讨乳腺癌分子分型与外周血循环肿瘤细胞(circulating tumor cell,CTC)的相关性。方法抽取116例乳腺癌及20例乳腺纤维腺瘤患者外周静脉血5 ml,利用密度梯度离心法富集单个核细胞,通过荧光定量PCR技术检测所获单个核细胞中细胞角蛋白(cytokeratin,CK)19 mRNA表达阳性的CTC,分析乳腺癌分子分型与CTC的关系。结果 116例乳腺癌患者中CTC阳性率为31%(36/116),20例乳腺纤维腺瘤患者均未检测出CTC。36例CTC阳性患者的中位CTC水平为1.65(1.18,2.87)个MCF-7细胞/2μg总RNA;116例乳腺癌患者中各分子亚型(luminal型、HER-2过表达型、basal-like型)所占比例分别为62.1%(72/116)、17.2%(20/116)、20.7%(24/116);各亚型(luminal型、HER-2过表达型、basal-like型)CTC阳性率分别为27.8%(20/72)、35%(7/20)、37.5%(9/24),差异无统计学意义(P=0.615),各亚型(luminal型、HER-2过表达型、basal-like型)CTC阳性患者的中位CTC水平分别为2.1(1.18,3.9)、1.37(1.12,2.12)、1.53(1.32,2.64)个MCF-7细胞/2μg总RNA,差异有统计学意义(P=0.046)。结论乳腺癌各分子亚型间CK-19 mR-NA阳性CTC水平存在差异,提示各亚型间临床异质性可能与患者CTC水平相关。Objective To investigate the correlation between molecular subtypes and circulating tumor cells（CTCs） in breast cancer.Methods The peripheral blood samples were collected from 116 patients with breast cancer and 20 patients with breast fibroadenoma（5 ml of each patient）.The mononuclear cells in the blood samples were enriched by density gradient centrifugation,and then were tested by quantitative real-time PCR（qPCR） to detect cytokeratin（CK） 19 mRNA-positive CTCs.The correlation between molecular subtypes and CTCs in breast cancer was analyzed.Results The positive rate of CTC in the breast cancer patients was 31%（36/116）,while no CTC was detected in the patients with breast fibroadenoma.The median of CK-19 mRNA-positive CTC（expressed as MCF-7 cell equivalents/2 μg total RNA） in the 36 CTC-positive patients was 1.65（1.18,2.87）.The proportion of luminal type,HER-2 type and basal-like type in the 116 breast cancer patients were 62.1%（72/116）,17.2%（20/116） and 20.7%（24/116）,respectively.The positive rates of CTC in these molecular subtypes were 27.8%（20/72）,35%（7/20） and 37.5%（9/24）,respectively,and no significant difference was observed（P=0.615）.The medians of CK-19 mRNA-positive CTC（expressed as MCF-7 cell equivalents/2 μg total RNA） of the three subtypes were 2.1（1.18,3.9）,1.37（1.12,2.12） and 1.53（1.32,2.64）,respectively,and there was significant difference between the different subtypes（P=0.046）.Conclusion There was significant difference of CK-19 mRNA-positive CTC level between different molecular subtypes of breast cancer,indicating the relationship between the CTC level and the clinical heterogeneity of molecular subtypes in patients with breast cancer.

关 键 词：乳腺肿瘤 分子亚型 循环肿瘤细胞 

分 类 号：R181.3[医药卫生—流行病学] R737.9[医药卫生—公共卫生与预防医学]