外周血循环肿瘤细胞联合CA153检测在乳腺癌筛查及分期预测中的应用价值  

Application Value of Peripheral Blood Circulating Tumor Cells Combined with CA153 Detection in Breast Cancer Screening and Stage Prediction

作　　者：邱晓阳[1] 吴璇[1] 刘君 詹晓芬[1] 陈志强 Qiu Xiaoyang;Wu Xuan;Liu Jun(Department of Pathology,Guangdong Province Shantou Central Hospital,Shantou 515031,China;Department of Pathology,Sun Yat-sen Universily Cancer Center,Guangzhou 510060,China)

机构地区：[1]广东省汕头市中心医院病理科,汕头515031 [2]中山大学附属肿瘤医院病理科,广州510060 [3]南方医科大学附属中山市博爱医院病理科,中山528400

出　　处：《华中科技大学学报（医学版）》2020年第3期331-337,共7页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：广东省医学科学技术研究基金立项课题(No.A2017321);中山市社会公益科技研究专项立项(No.2018B1035)。

摘　　要：目的探讨外周血循环肿瘤细胞(CTC)、糖类抗原153(CA153)及联合检测在乳腺癌筛查及分期预测中的应用价值。方法随机选取185例健康体检者(对照组)、163例乳腺良性病变患者(良性组)、139例乳腺癌患者(恶性组)作为受试者,检测其术前CTC和CA153水平。比较CTC、CA153及联合检测在3组受试者中的阳性率、检测值的差异,并进一步分析3种检测在恶性组临床分期中阳性率、检测值的差异,综合评估3种检测对乳腺癌的诊断效能及分期预测的差异。结果①CEP8/17探针检测的乳腺癌患者扩增型CTC表现为:CEP8、CEP17单染色体扩增型CTC和CEP8/17双染色体扩增型CTC。②恶性组的CTC、CA153及联合检测阳性率均为最高,与对照组、良性组相比,差异均具有统计学意义(均P<0.01)。③恶性组的CTC数量、CA153数值均为最高,与对照组、良性组相比,差异均具有统计学意义(均P<0.01)。④恶性组Ⅳ期CTC的阳性率最高,Ⅰ与Ⅲ期、Ⅰ与Ⅳ期之间CTC阳性率差异具有统计学意义(均P<0.01);恶性组Ⅳ期CA153的阳性率最高,Ⅰ与Ⅲ期、Ⅰ与Ⅳ期、Ⅱ与Ⅳ期之间CA153阳性率差异具有统计学意义(均P<0.01);恶性组Ⅳ期联合检测的阳性率最高,Ⅰ与Ⅱ期、Ⅰ与Ⅲ期、Ⅰ与Ⅳ期患者之间联合检测阳性率差异具有统计学意义(均P<0.01)。⑤恶性组Ⅳ期的CTC数值最高,各期之间的CTC数量差异均具有统计学意义(均P<0.01);恶性组Ⅳ期的CA153数值最高,Ⅰ与Ⅱ期、Ⅰ与Ⅲ期、Ⅰ与Ⅳ期患者间CA153数值差异有统计学意义(均P<0.01)。⑥联合检测的灵敏度、符合率、阴性预测值均较CTC、CA153检测高,整体上提高了乳腺癌的诊断效能。⑦CTC、CA153及联合检测诊断乳腺癌的曲线下面积(AUC)分别为0.754、0.719、0.838,联合检测的AUC明显大于CTC与CA153检测,差异均具有统计学意义(均P<0.05)。结论CTC、CA153均为乳腺癌发生的独立危险因素,在乳腺癌的筛查及分期中�Objective To investigate the value of circulating tumor cells(CTC),carbohydrate antigen 153(CA153)and combined detection in screening and staging of breast cancer.Methods 185 healthy subjects(control group),163 patients with benign breast lesions(benign group)and 139 patients with breast cancer(malignant group)were randomly selected as subjects to detect the preoperative levels of CTC and CA153.The difference of positive rate and detection value of CTC,CA153 and combined detection were compared in the three groups of subjects,and the difference of positive rate and detection value of three kinds of detection in clinical staging of malignant group further analyzed,and the difference of diagnostic efficiency and staging prediction of three kinds of detection for breast cancer comprehensively evaluated.Results①The amplified CTC of breast cancer patients detected by CEP8/17 probe showed CEP8,CEP17 single-chromosome amplified CTC and CEP8/17 double-chromosome amplified CTC.②The positive rates of CTC,CA153 and combined detection in malignant group were the highest,and the difference was statistically significant compared with the control group and benign group(P<0.01).③The number of CTCs and CA153 in malignant group were the highest,and the difference was statistically significant compared with the control group and benign group(P<0.01).④The positive rate of stageⅣCTC was the highest in malignant group.The positive rate of CTC between stageⅠandⅢ,stageⅠandⅣhad statistical significance(P<0.01).The positive rate of stageⅣCA153 was the highest in malignant group.The positive rates of CA153 between stageⅠandⅢ,ⅠandⅣ,ⅡandⅣwere significantly different(P<0.01).The positive rate of stageⅣby combined detection was the highest in malignant group.There were significant differences in the positive rates of combined detection between stageⅠandⅡ,ⅠandⅢ,ⅠandⅣpatients(P<0.01).⑤The number of CTCs in stageⅣof malignant group was the highest,and there was significant difference in the number

关 键 词：循环肿瘤细胞 糖类抗原153 乳腺癌 联合检测 

分 类 号：R730.43[医药卫生—肿瘤]