乳腺癌骨转移与外周血循环肿瘤细胞上皮-间充质转化表型的关系  

The relationship between bone metastasis of breast cancer and epithelial-mesenchymal transition phenotype of circulating tumor cell in peripheral blood

作　　者：李振芬 付茹俊 方丹丹 LI Zhenfen;FU Rujun;FANG Dandan(Department of Pathology,Kaifeng Cancer Hospital,Kaifeng 475000,He’nan,China)

机构地区：[1]开封市肿瘤医院病理科,河南开封4750000

出　　处：《癌症进展》2019年第3期331-334,共4页Oncology Progress

摘　　要：目的探讨乳腺癌骨转移与外周血循环肿瘤细胞(CTC)上皮-间充质转化(EMT)表型的关系。方法回顾性分析270例乳腺癌患者的临床资料。随访2年,根据随访期间是否发生骨转移将患者分为骨转移组(n=30)和无骨转移组(n=240)。于术前采集两组患者的外周血样本,采用免疫磁珠阴性富集法捕获外周血CTC,采用流式细胞仪对CTC和CTC EMT表型进行鉴定;比较两组患者的CTC检出情况,分析乳腺癌患者发生骨转移的影响因素及CTC EMT表型分子标志物TWIST和vimentin蛋白表达的相关性。结果骨转移组中CTC的检出率明显高于无骨转移组,差异有统计学意义(P﹤0.01)。单因素分析结果显示,骨转移组与无骨转移组患者的年龄、分化程度、淋巴结转移情况比较,差异均有统计学意义(P﹤0.05);骨转移组与无骨转移组患者的肿瘤部位、组织学类型、TNM分期比较,差异均无统计学意义(P﹥0.05)。Logistic多因素回归分析结果显示,TWIST阳性表达、vimentin阳性表达和淋巴结转移是乳腺癌患者发生骨转移的独立危险因素(P﹤0.05)。Spearman秩相关分析结果显示,骨转移组中TWIST和vimentin蛋白的表达呈正相关(r=0.715,P﹤0.05)。结论术前乳腺癌外周血CTC EMT表型分子标志物TWIST和vimentin的阳性表达与乳腺癌患者术后发生骨转移有关,对乳腺癌骨转移的早期预测具有一定的临床意义。Objective To explore the relationship between bone metastasis of breast cancer and epithelial-mesenchymal transition (EMT) phenotype of circulating tumor cell (CTC) in peripheral blood. Method The clinical data of 270 cases with breast cancer were retrospectively analyzed. All subjects were followed up for 2 years, and were stratified as bone metastasis group and non-bone metastasis group according to the presence of bone metastasis in the follow-up period, with 30 cases and 240 cases in each group, respectively. The peripheral blood samples were collected from all subjects before surgery, from which the CTC in peripheral blood were captured using negative enrichment by immunomagnetic nanobeads, besides, flow cytometry was applied to identify the phenotype of CTC and CTC EMT;additionally, the detection of CTC in both groups were compared, factors influencing the occurrence of bone metastasis and the correlation between the protein expression of molecular marker TWIST and vimentin of CTC EMT phenotype was investigated. Result The detection rate of CTC in bone metastasis group was significantly higher than that in non-bone metastasis group (P<0.01). The univariate analysis showed that there were significant differences in age, differentiation degree and lymph node metastasis between bone metastasis group and non-bone metastasis group (P<0.05);while no significant differences were observed in regard to tumor sites, histological type and TNM stage between the two groups (P>0.05). The Logistic multivariate regression analysis indicated that, positive expression of TWIST and vimentin, and lymph node metastasis were independent risk factors for bone metastasis in breast cancer patients (P<0.05). The Spearman’s rank correlation analysis revealed that, the expression of TWIST and vimentin protein was positively correlated in bone metastasis group (r=0.715, P<0.05). Conclusion The presence of preoperative expression of EMT phenotype of CTC (TWIST/vimentin) in peripheral blood of breast cancer is closely related to the oc

关 键 词：乳腺癌 循环肿瘤细胞 骨转移 上皮-间充质转化 

分 类 号：R737.9[医药卫生—肿瘤]