乳腺癌患者外周血中内皮祖细胞检测的临床意义  

Determination of endothelial progenitor cells in peripheral blood of breast cancer patients

作　　者：王佳铭[1] 魏刚[1] 马震[2] 王长青[1] 严时 刘岩[3] 李慧[3] Wang Jiaming;Wei Gang;Ma Zhen;Wang Changqing;Yan Shi;Liu Yan;Li Hui(Department of Breast Oncologic Surgery,3Translational Research Laboratory of Oncology,Jilin Cancer Hospital,Changchun 130012,China;Department of Breast Diseases,People＇s Hospital of Jilin Province,Changchun 130012,China)

机构地区：[1]吉林省肿瘤医院乳腺肿瘤外科,长春130012 [2]吉林省人民医院乳腺科,长春130012 [3]吉林省肿瘤医院肿瘤转化医学实验室,长春130012

出　　处：《中华乳腺病杂志（电子版）》2018年第5期270-275,共6页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：吉林省卫生厅课题(2017J027,2015Z095);吉林省科技厅课题(20140101170JC)

摘　　要：目的探讨乳腺癌患者外周血中内皮祖细胞(EPCs)检测的临床意义。方法采用前瞻性研究方法,收集2014年3月至2015年3月吉林省肿瘤医院收治的、病理学证实的70例浸润性乳腺导管癌患者、61例乳腺纤维腺瘤患者和68名健康人的外周血,利用流式细胞术检测EPCs[CD34、CD133和血管内皮生长因子受体(VEGFR)-2阳性细胞]水平。采用Fisher确切概率检验和KruskalWallis H检验比较3组间EPCs阳性率及其表面标志物CD34、CD133和VEGFR-2表达量的差异,并用Fisher确切概率检验分析乳腺癌患者EPCs阳性率与临床病理特征的关系;采用t检验比较不同临床分期和不同淋巴结转移状态患者间EPCs表面标志物CD34、CD133和VEGFR-2表达量的差异。结果在乳腺癌患者、乳腺纤维腺瘤患者和健康人外周血中,EPCs阳性率及其表面标志物CD34、CD133和VEGFR-2表达量的差异均有统计学意义(χ~2=12. 811,P<0. 001; F=15. 275,P<0. 001);健康人及乳腺纤维腺瘤组均未检测到EPCs,组间两两比较显示,EPCs表面标志物CD34、CD133和VEGFR-2在乳腺癌患者外周血中的表达量[M(P25～P75):0. 006%(0. 003%～6. 008%)]明显高于健康人及乳腺纤维腺瘤患者(P=0. 002、0. 003),乳腺癌组EPCs阳性率也显著高于健康人及乳腺纤维腺瘤患者[11. 4%(8/70)分别比0(0/68)、0(0/61),P=0. 006、0. 007]。但EPCs阳性率与乳腺癌患者的年龄、ER、PR和HER-2状态均无关(P均>0. 050)。进一步分析EPCs阳性的8例乳腺癌患者临床资料后发现,Ⅰ期患者(n=4)外周血中EPCs表面标志物CD34、CD133和VEGFR-2的表达量明显低于Ⅱ～Ⅳ期患者(n=4)[(0. 300±0. 162)%比(1. 130±0. 318)%,t=4. 640,P=0. 004],而淋巴结转移者(n=4) EPCs表面标志物CD34、CD133和VEGFR-2的表达量明显高于未转移者(n=4)[(1. 062±0. 424)%比(0. 370±0. 287)%,t=2. 700,P=0. 040]。结论乳腺癌患者外周血中EPCs表面标志CD34、CD133和VEGFR-2表达水平较高,其可能是一种潜在的生物标志物和治疗ObjectiveTo investigate the clinical significance of endothelial progenitor cells （EPCs） in peripheral blood of breast cancer patients.Methods Peripheral blood from healthy volunteers （control group, n =68）,breast fibroadenoma patients （benign group, n =61） and patients with invasive ductal breast cancer （ n =70） in Jilin Cancer Hospital from March 2014 to March 2015 were collected for a prospective study. The concentration of EPCs （marked by CD34, CD133 and VEGFR-2 positive） was determined by flow cytometry. Fisher’s exact probability test and Kruskal-Wallis H test were used to compare the positive rate of EPCs and the expression of CD34, CD133 and VEGFR-2 among three groups. Fisher’s exact probability test was used to analyze the relationship between the positive rate of EPCs and clinicopathological features in breast cancer patients. The expression of CD34, CD133 and VEGFR-2 （surface markers of EPCs） was compared in the patients with different clinical stages and lymph node metastasis status by t test.Results The positive rate of EPCs and the expression of CD34, CD133 and VEGFR-2 presented a significant difference among three groups （χ 2=12.811, P 〈0.001; F =15.275, P 〈0.001）. EPCs were not detected in control group and benign group.The expression of CD34, CD133 and VEGFR-2in breast cancer group was 0.006%（0.003%-0.008%）[ M（P 25 -P 75 ） ], significantly higher than that in control group or benign group （ P =0.002 and P =0.003）. The positive rate of EPCs was significantly higher than that in control group or benign group [11.4% （8/70） vs 0 （0/68）, P =0.006; 11.4% （8/70） vs 0 （0/61）, P =0.007]. The positive rate of EPCs was not correlated with patient age, ER, PR and HER-2 status （all P 〉0.05）. In eight breast cancer patients with EPCs positive, the expression of CD34, CD133 and VEGFR-2 in stageⅠbreast cancer was significantly lower than that in stage Ⅱ- Ⅳ breast cancer [（0.300±0.162）% vs （1.130±0.318）%, t =4.640, P =0.004）,

关 键 词：乳腺肿瘤 内皮 血管 血管内皮生长因子受体2 抗原 CD 内皮祖细胞 

分 类 号：R737.9[医药卫生—肿瘤]