乳腺癌患者外周血循环肿瘤细胞阴性富集法检测及其临床意义  

Detection of circulating tumor cells in patients with breast cancer using negative enrichment of immune magnetic beads and its clinical significance

作　　者：吴江[1] 胡晨曦[1] 惠开元[1] 宋大安[1] 乔云[1] 蒋晓东[1] 

机构地区：[1]南京医科大学连云港临床医学院,江苏连云港222002

出　　处：《中华肿瘤防治杂志》2017年第5期302-306,311,共6页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的循环肿瘤细胞(circulating tumor cells,CTC)的检测作为一种新兴的检测方法,在临床实践中拥有广阔的应用前景。本研究通过阴性富集法检测乳腺癌患者外周血CTC,探讨CTC水平与其分子分型及临床特征的相关性,研究其临床意义。方法选取连云港市第一人民医院2015-08-18-2016-02-20接受CTC检测的乳腺癌患者152例为研究对象,收集临床资料,选择同期该院29例乳腺良性疾病患者作为对照组。采用免疫磁珠阴性富集及免疫荧光原位杂交技术(fluorescence in situ hybridization,FISH)检测CD45^-/CEP^+/DAPI^+的CTC,并结合乳腺癌分子分型和临床特征进行统计学分析。结果 152例乳腺癌患者与29例乳腺良性疾病患者进行ROC曲线分析,比较不同切点的敏感度及特异度,经计算Youden指数最高为0.390,对应切点为≥2.5,故取CTC个数≥3为阳性指标。152例乳腺癌患者中CTC阳性率Ⅰ~Ⅱ期为41.5%,Ⅲ期为60.0%,Ⅳ期为73.9%,差异有统计学意义,χ~2=9.360,P=0.009。CTC与乳腺癌分子分型无相关性,P>0.05,与肿瘤原发灶分期、区域淋巴结转移、激素受体状况及HER2表达均无相关性,P>0.05。但与是否发生远处转移密切相关,χ~2=5.863,P=0.015。结论 CTC与乳腺癌分子分型无明显相关,但与患者临床分期、是否发生转移密切相关,检测CTC有利于更准确的评估病情。OBJECTIVE Detection of circulating tumor cells （CTC） as a new detection method has broad application prospects in clinical practice. This study detected the circulating tumor cells in patients with breast cancer by negative enrichment of immune magnetic beads to discuss the correlation between CTC and molecular subtypes and clinical characteristics of breast cancer. METHODS Totally 152 breast cancer patients from August 18,2015 and February 20, 2016 who accepted CTC detection were studied. Negative enrichment of immune magnetic beads and fluorescence in situ hybridization （FISH） were applied to collect the CD45^-/CEP^＋/DAPI^＋ of CTC, the correlation between CTC and molecular subtypes and clinical characteristics of breast cancer were analyzed. RESULTS Comparing the Youden index at different tangent point of the ROC curve through analysis the 152 patients with breast cancer and 29 cases of benign breast disease patients, the biggest was 0. 390, the corresponding tangent point was 2.5 or higher, so take the CTC number 3 or more positive indicator. In 152 patients with stage Ⅰ to Ⅱ , Ⅲ and Ⅳ, the positive rates of CTC were 41.5%, 60.0% and 73.9 % respectively, the difference was significant（χ^2 = 9. 360, P = 0. 009）. There was no significant difference between CTC and molecular subtypes of breast cancer（P〉0.05）. The presence of CTC is uncorrelated with patients＇ T stage, N stage, hormone receptor and HER2 expression（P〉0.05）. In addition CTC is correlated with M stage（χ^2 = 5. 863, P= 0. 015）. CONCLUSIONS CTC is uncorrelated with molecular subtypes of breast cancer, but closely correlated with TNM stage and the occurrence of metastasis. The detection of CTC is conducive to more accurate assessment of the disease.

关 键 词：循环肿瘤细胞 乳腺癌 分子分型 临床特征 

分 类 号：R737.9[医药卫生—肿瘤]