CK19联合hMAM检测乳腺癌循环肿瘤细胞的临床价值  

Clinical value of hMAM combined with CK19 detection for circulating tumor cells in patients with breast cancer

作　　者：鲍慧铮[1] 陈力[2] 李思莹[1] 徐娜[1] 李忠锟 左淑波[1] 于秀艳[3] 刘岩[4] 赵丹丹[4] 李慧[4] 

机构地区：[1]吉林省肿瘤医院淋巴血液科(内5科),吉林长春130012 [2]吉林大学口腔医学院放射科,吉林长春130021 [3]吉林省肿瘤医院检验科,吉林长春130012 [4]吉林省肿瘤医院血液肿瘤病重点实验室,吉林长春130012

出　　处：《肿瘤》2014年第2期153-157,共5页Tumor

基　　金：吉林省卫生厅科研课题(编号:2010Z086);吉林省自然科学基金资助项目(编号:201215215)

摘　　要：目的:探讨细胞角蛋白19(cytokeratin 19,CK19)和人乳腺珠蛋白(human mammaglobin,hMAM)在检测乳腺癌外周血循环肿瘤细胞(circulating tumor cells,CTCs)中的临床价值。方法:应用实时荧光定量PCR法联合2种生物标志物CK19和hMAM检测乳腺癌循环肿瘤细胞的阳性率,并分析它们与患者临床病理特征的相关性。结果:乳腺癌患者CK19、hMAM及二者联合检测的阳性率分别为45.5%(20/44)、38.6%(17/44)和56.8%(25/44)。CK19联合hMAM检测的阳性率与患者的淋巴结转移状态相关(P=0.031)。治疗前乳腺癌患者CK19、hMAM及二者联合检测的阳性率均显著高于健康对照组(P=0.000 3、P=0.000 1和P=0.000 1);两个化疗周期后,联合检测结果由阳性转为阴性的患者在TNMⅢ期和Ⅳ期中分别为5例和4例,转阴率差异有统计学意义(P=0.025 3和P=0.045 5);但在TNMⅠ和Ⅱ期患者中,CK19、hMAM或二者联合检测的阳性患者经化疗后其数量均下降,且联合检测的阳性患者数量仍高于单检测的阳性患者数量,但差异均无统计学意义(P>0.05)。结论:CK19联合hMAM可作为诊断乳腺癌患者循环肿瘤细胞的生物标志物,对于指导乳腺癌患者的早期微转移、治疗和预后判断具有重要意义。Objective： To explore the clinical value of cytokeratin 19 （CK19） and human mammaglobin （hMAM） in the detection of circulating tumor cells （CTCs） in peripheral blood of patients with breast cancer. Methods： Expressions of CK19 and hMAM in blood were identified by real-time fluorescent quantitative PCR, and the correlations between CK19, hMAM and the clinicopathologic features were analyzed. Results： In breast cancer patients, the rates of diagnostic positive detection of individual CK19 or hMAM and the combination of these two biomarkers were 45.5% （20/44）, 38.6% （1 7/44） and 56.8% （25/44）, respectively. The expression of combined biomarkers was correlated with lymph node metastasis （P = 0.031）. The rates of diagnostic positive detection of CK19, hMAM and the combination biomarkers were significantly higher in breast cancer patients prior to treatment than those in the healthy control group （P = 0.000 3, P = 0.000 1 and P = 0.000 1, respectively）. After two-cycle chemotherapy, CTCs which were positive at baseline presented as negative in 5 stage III patients and 4 stage IV patients （P = 0.025 3 and P = 0.045 5）. However, the number of CTCs-positive patients at stages I -II decreased no matter using CK19, hMAM or CK19 plus hMAM as biomarker, leaving more CTCs-positive patients incombined biomarker group than that in single biomarker group, but there was no statistical significance. Conclusion： The combined panel of both hMAM and CK19 may serve as representative biomarkers for CTCs, thus it presents potentially significant value for monitoring early metastasis, therapeutic efficacy and prognosis for the patients with breast cancer.

关 键 词：乳腺肿瘤 肿瘤循环细胞 角蛋白19 人乳腺珠蛋白 基因表达 

分 类 号：R737.9[医药卫生—肿瘤]