曲妥珠单抗对HER-2阳性早期乳腺癌外周血循环肿瘤细胞的影响  

Effects of Herceptin on circulating tumor cells in HER-2 positive early breast cancer

作　　者：张聚良[1] 姚青[1] 陈江浩[1] 王廷[1] 王辉[1] 樊菁[1] 凌瑞[1] 易军[1] 袁时芳[1] 王岭[1] 

机构地区：[1]第四军医大学西京医院血管内分泌外科,陕西西安710032

出　　处：《现代肿瘤医学》2013年第2期279-281,共3页Journal of Modern Oncology

摘　　要：目的:检测HER-2阳性的早期乳腺癌患者应用曲妥珠单抗治疗前后外周血循环肿瘤细胞(CTCs)的变化,探讨HER-2基因及曲妥珠单抗对CTCs的影响。方法:应用实时定量逆转录-聚合酶链反应(qRT-PCR)方法检测15例HER-2阳性乳腺癌及18例HER-2阴性乳腺癌患者术前及化疗后外周血CK19的表达水平,其中10例HER-2阳性乳腺癌患者在化疗结束后,继续应用曲妥珠单抗治疗,3月后再次抽取外周血,qRT-PCR检测CK-19的表达水平。结果:手术前,HER-2阳性乳腺癌患者外周血CK19表达均为阳性,而HER-2阴性患者6例CK19表达阳性(33.3%),二者差异显著。化疗后,14例HER-2阳性乳腺癌患者CK19表达阳性(93.3%),而HER-2阴性患者仅2例表达阳性,二者差异显著。10例HER-2阳性乳腺癌患者化疗后继续应用曲妥珠单抗治疗3月后,外周血CK19的表达明显下降(81.66±68.65 vs 23.35±19.27,P=0.025)。结论:HER-2基因的表达与早期乳腺癌患者外周血CTCs密切相关,而曲妥珠单抗可以降低CTCs的数量,提示CTCs可以作为曲妥珠单抗治疗疗效的早期预测指标。Objective： To explore the variation of peripheral blood circulating tumor cells in HER - 2 positive early breast cancer before and after Herceptin therapy and the effects of Herceptin on circulating tumor cells. Methods： CK19 mRNA in peripheral blood was detected by qRT - PCR as an index of circulating tumor cells in cases of 15 HER -2 positive breast cancer and 18 HER -2 negative breast cancer preoperation and after adjuvant chemotherapy.10 cases of HER -2 positive breast cancer continued Herceptin therapy and then were detected again for CK19 mRNA 3 months later. Results： CK 19 mRNA was found in peripheral blood of all cases of HER - 2 positive and 6 cases of HER - 2 negative breast cancer preoperation. There was a significant difference between the two groups. After 6 cycle＇s adjuvant chemotherapy, CK19 positive rates in HER -2 positive and HER -2 negative breast cancer were 93.3% and 11.1% ,respectively. Significant difference between the two groups was found. After 3 months Herceptin therapy, expression of C K19 mRNA declined significantly in 10 cases of HER -2 positive breast cancer （113.66 ± 88.65 vs 63.35 ± 49.27, P = 0. 025 ）. Conclusion： Circulating tumor cells correlate with HER - 2 gene expression. Herceptin, a monoclonal antibody for HER - 2, can reduce the circulating tumor cells in breast cancer. Thus circulating tumor cells may be a predictive factor for early effects of Hereeptin therapy.

关 键 词：曲妥珠单抗 乳腺癌 循环肿瘤细胞 

分 类 号：R737.9[医药卫生—肿瘤]