循环肿瘤细胞在晚期乳腺癌中的应用价值  

The application value of circulating tumor cells in advanced breast cancer

作　　者：欧阳航 陈德波[2] 骆时木 杨培东 吴一波[1] 张志珊[1] OUYANG Hang;CHEN Debo;LUO Shimu;YANG Peidong;WU Yibo;ZHANG Zhishan(Department of Clinical Laboratory,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China;Department of Breast Surgery,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院检验科,福建泉州362000 [2]福建医科大学附属泉州第一医院乳腺外科,福建泉州362000

出　　处：《国际检验医学杂志》2021年第12期1455-1459,1464,共6页International Journal of Laboratory Medicine

基　　金：福建省卫生和计划生育委员会中青年骨干人才培养项目(2017-ZQN-77)。

摘　　要：目的探讨循环肿瘤细胞(CTC)在晚期乳腺癌中的应用价值。方法选择2018年6月至2020年1月该院乳腺外科收治的经病理检查确诊为晚期乳腺癌的女性患者43例为研究组,另选取健康体检女性15例为对照组。采用差相富集-免疫荧光原位杂交计数法检测CTC。比较治疗前CTC与常用肿瘤标志物[癌胚抗原(CEA)、糖类抗原15-3(CA15-3)、糖类抗原125(CA125)]诊断晚期乳腺癌的效能;分析治疗前CTC阳性率与晚期乳腺癌患者临床特征的关系;分析治疗前后CTC阳性率及数量变化与患者疗效的关系。结果治疗前研究组CTC阳性率为86.05%,高于对照组的CTC阳性率(6.67%),差异有统计学意义(P<0.05)。治疗前,与CEA、CA125、CA15-3相比,CTC诊断晚期乳腺癌的曲线下面积最大,为0.897,特异度、灵敏度、准确度分别为93.33%、86.05%、87.93%。治疗前CTC阳性率与晚期乳腺癌患者的年龄、绝经状态、临床分期、Ki67标记指数、人类表皮生长因子受体-2、雌激素受体、孕激素受体均无关(P>0.05)。治疗后CTC阳性患者的治疗有效率低于治疗后CTC阴性患者,差异有统计学意义(P<0.05)。CTC数量减少患者的治疗有效率明显高于CTC数量增加的患者,差异有统计学意义(P<0.05)。结论CTC在晚期乳腺癌的诊断及疗效评估方面具有一定的临床应用价值。Objective To explore the application value of circulating tumor cells(CTC)in advanced breast cancer.Methods From June 2018 to January 2020,a total of 43 female patients with advanced breast cancer diagnosed by pathological examination were selected as the research group,and 15 healthy female took physical examination were selected as the control group.Differential enrichment-immunofluorescence in situ hybridization counting method was used to detect CTC.Compared the efficacy of CTC and common tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 15-3(CA15-3),carbohydrate antigen 125(CA125)]in the diagnosis of advanced breast cancer before treatment.Analyzed the relationship between the positive rate of CTC before treatment and the clinical characteristics of patients with advanced breast cancer.Analyzed the relationship between the positive rate and quantity change of CTC before and after treatment and the patient′s curative effect.Results Before treatment,the positive rate of CTC in the study group was 86.05%,which was higher than the positive rate of CTC in the control group(6.67%),the difference was statistically significant(P<0.05).Before treatment,compared with CEA,CA125 and CA15-3,CTC had the largest area under the curve in the diagnosis of advanced breast cancer,which was 0.897.The specificity,sensitivity and accuracy were 93.33%,86.05%and 87.93%respectively.The positive rate of CTC before treatment was not correlated with age,menopausal status,clinical stage,Ki67 marker index,human epidermal growth factor receptor 2,estrogen receptor and progesterone receptor(P>0.05).After treatment,the effective rate of CTC positive patients was lower than that of CTC negative patients,the difference was statistically significant(P<0.05).The effective rate of patients with decreased number of CTC was significantly higher than that of patients with increased number of CTC,the difference was statistically significant(P<0.05).Conclusion CTC has a certain clinical value in the diagnosis and efficacy evaluation o

关 键 词：晚期乳腺癌 循环肿瘤细胞 疗效监测 

分 类 号：R737.9[医药卫生—肿瘤]