乳腺癌外周血微转移与远处转移的相关性

背景与目的:乳腺癌是一种全身性疾病,早期就可发生血行转移.本研究采用流式细胞仪定量检测乳腺疾病患者外周血肿瘤细胞含量,探讨外周血肿瘤细胞含量与远处脏器转移的相关性.方法:以人细胞角蛋白抗体和CD45抗体双色免疫标记,应用多参数流式细胞仪方法检测65例乳腺癌患者术前和10例乳腺良性病变及8例健康献血者外周血标本中肿瘤细胞含量.结果:65例乳腺癌患者中,57例检测出肿瘤细胞,阳性率为87.7%;乳腺良性病变、健康献血者外周血中未检测到肿瘤细胞.外周血肿瘤细胞阳性率与肿瘤T分期及N分期具有相关性(r=0.271,P=0.017;r=0.393,P=0.002).除2例失访外,63例患者经过5年随诊,25例出现远处脏器转移,5年转移率为39.7%.所有远处转移病例均为外周血检测阳性患者,8例术前外周血检测阴性的患者均未发现远处转移,两组比较差异有统计学意义(P=0.014);而远处转移与肿瘤T分期、N分期均无明显相关性.结论:术前外周血肿瘤细胞数量与远处转移具有明显相关性,多参数流式细胞术检测乳腺癌患者外周血肿瘤细胞,对指导乳腺癌的个体化治疗具有潜在的应用价值.

Correlation of peripheral blood micrometastasis to distant metastasis of breast cancer

BACKGROUND & OBJECTIVE: Breast cancer, a whole body disease, can metastasize at early stage. This study was to explore the correlation of peripheral blood cancer cell (PBCC) content to distant metastasis of breast cancer. METHODS: The PBCC content of 65 breast cancer patients and 8 healthy donors was detected by multi-parameter flow cytometry (FCM) with CD45 and cytokeratin staining. RESULTS: Cancer cells were detected in peripheral blood samples from 57 of the 65 patients; the positive rate was 87.7%. No cancer cell was found in peripheral blood samples from healthy donors. The positive rate of PBCCs was correlated to T stage (r=0.271,P=0.017) and N stage (r=0.393, P=0.002). The patients were followed for 5 years; 2 were lost. Distant metastasis was found in 25 patients with PBCCs. In contrast, no metastasis was found in 8 patients without PBCCs (P<0.05). CONCLUSION: Preoperative PBCC content is closely related to distant metastasis of breast cancer. The detection of PBCCs might be useful for individual treatment decision for breast cancer.