乳腺癌病人循环肿瘤细胞检测的临床意义

目的:探讨乳腺癌外周静脉血中循环肿瘤细胞(circulating tumor cells,CTCs)检测的临床意义.方法:收集女性乳腺癌病人60例,在新阶段治疗前采集病人外周静脉血,采用密度梯度离心法联合流式细胞术法检测CTCs,免疫组织化学法检测ER、PR、HER-2、p53、Ki-67表达.同期选取20名健康女性志愿者作为阴性对照组.结果:观察组CTCs阳性表达率为38.3% (23/60),对照组均未检出CTCs阳性表达,2组CTCs阳性表达差异有统计学意义(P<0.01).不同年龄、不同病理类型病人间CTCs阳性表达差异均无统计学意义(P>0.05);不同TNM分期病人CTCs阳性表达差异有统计学意义(P<0.01);转移性乳腺癌病人CTCs阳性表达明显高于非转移性病人(P<0.01).不同ER、PR、HER-2、Ki-67表达病人的CTCs阳性表达差异均无统计学意义(P>0.05),不同分子分型病人间的CTCs阳性表达差异亦无统计学意义(P>0.05).结论:CTCs与乳腺癌TNM分期及肿瘤细胞转移有关,对指导乳腺癌的诊断、治疗及预后判断有重要意义.

Clinical significance of the detection of circulating tumor cells in breast cancer

Objective:To investigate the clinical significance of the detection of circulating tumor cells(CTCs) in peripheral venous blood of breast cancer patients. Methods:The CTCs in peripheral venous blood of 60 patients with breast cancer before new stage treatment were examined using density gradient centrifugation combined with flow cytometry(FCM),and the expression levels of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2),p53 and Ki-67 were detected using the immunohistochemical method.Twenty healthy female volunteers were set as the control group at the same time.Results:The positive rate of CTCs in observation group was 38.3%(23/60),the positive CTCs was not detected in control group,and the difference of the positive expression of CTCs between two groups was statistically significant(P<0.01).The differences of the positive expression of CTCs in different ages and pathological types patients were not statistically significant(P >0.05).The difference of the positive expression of CTCs in different TNM stages patients was statistically significant(P <0. 01). The positive expression of CTCs in metastatic breast cancer patients was significantly higher than that in nonmetastatic breast cancer patients(P<0.01).The differences of the positive expression of CTCs in patients with different ER,PR,HER-2,Ki-67 and molecular classification were not statistically significant(P>0.05). Conclusions:The CTCs is related to the TNM staging and metastatsis of breast cancer,which has a great significance in the diagnosis,treatment and evaluating prognosis of breast cancer.