外周血循环肿瘤细胞在乳腺癌中的表达意义  

Value of Peripheral Blood Circulating Tumor Cell Detection in the Diagnosis of Breast Cancer

作　　者：张娜贤 孙新超[1] 丁旭萌[1] 刘柳[1] 李刚 杨明 姬玉涵 刘丽娜[1] ZHANG Naxian;SUN Xinchao;DING Xumeng(Nanyang Second People's Hospital,Nanyang,411302)

机构地区：[1]河南省南阳市第二人民医院,411302

出　　处：《实用癌症杂志》2020年第7期1170-1173,共4页The Practical Journal of Cancer

基　　金：2016年度河南省医学科技攻关计划项目(编号:201602378)。

摘　　要：目的探讨阴性富集联合免疫荧光原位杂交技术(FISH)检测外周血循环肿瘤细胞(CTC)阳性表达在乳腺癌中的临床意义。方法选取乳腺癌患者80例为研究对象,收集所有患者临床资料,采用阴性富集联合FISH检测所有患者外周血CTC水平变化,分析CTC表达情况与乳腺癌患者临床病理特征、免疫组化和分子分型的关系,采用Kaplan-Meier生存分析CTC与无进展生存期(PFS)之间的关系。结果乳腺癌患者CTC阳性表达率分别为Ⅰ~Ⅱ期40.82%、Ⅲ期61.11%、Ⅳ期69.23%,差异具有统计学意义(P<0.05);乳腺癌M1期转移的患者CTC阳性率为69.23%,明显高于M0期患者的46.27%,差异具有统计学意义(P<0.05);CTC阳性率与乳腺癌患者ER、RR、HER2状态无明显关系(P>0.05);分子分型Luminal A、Luminal B、HER2阳性、三阴型与CTC的阳性率无明显相关(P>0.05)。对患者随访至2018年12月,出现局部复发及远处转移的患者共17例,Kaplan-Meier生存分析结果显示,CTC阳性表达乳腺癌患者PFS明显短于CTC阴性表达(P<0.05)。结论阴性富集联合FISH检测乳腺癌患者的外周血CTC水平与乳腺癌临床分期、远处转移及预后生存期相关,证实了CTC是乳腺癌发生远处转移的重要前提。Objective To analyze analyze the clinical value of peripheral blood circulating tumor cell(CTC)detection by negative enrichment combined with fluorescence in situ hybridization(FISH)in diagnosis of breast cancer.Methods Clinical data of 80 patients with breast cancer were collected.The changes of CTC level in peripheral blood of all patients were detected by negative enrichment combined with FISH.The relationship among CTC expression,clinicopathological characteristics,immunohistochemistry and molecular typing of breast cancer patients was analyzed.The Kaplan-Meier survival analysis was used to analyze the relationship between CTC and progression-free survival(PFS).Results The positive expression rate of CTC in breast cancer patients was 40.82%in stageⅠ~Ⅱ,61.11%in stageⅢand 69.23%in stageⅣ,with statistical significance(P<0.05);the positive rate of CTC in patients with M1 stage metastasis was significantly higher than that in patients with M0 stage(69.23%vs46.27%,P<0.05).The positive rate of CTC had no significant correlation with ER,RR and HER2 status of breast cancer patients(P>0.05).There was no significant correlation between the positive rate of CTC and molecular typing Luminal A,Luminal B,HER2 positive and triple negative(P>0.05).At the end of follow-up in December 2018,a total of 17 patients had local recurrence and distant metastasis.Kaplan-Meier survival analysis showed that the PFS of breast cancer patients with positive CTC expression was significantly shorter than that with negative CTC expression(P<0.05).Conclusion Peripheral blood CTC level in breast cancer patients detected by negative enrichment combined with FISH are correlated with clinical stage,distant metastasis,prognosis and survival of patients,which proves that CTC is an important prerequisite for distant metastasis of breast cancer.

关 键 词：CTC FISH 乳腺癌 临床意义 

分 类 号：R737.9[医药卫生—肿瘤]