早期乳腺癌血清VEGF水平与骨髓微转移的相关性及临床意义

目的：检测早期乳腺癌患者血清中VEGF及骨髓标本中CK19的表达水平,探讨二者的相互关系及临床意义。方法：应用ELISA法分别检测6例乳腺纤维腺瘤及64例乳腺癌患者血清中VEGF的水平,同时抽取相应的骨髓血标本,应用实时定量逆转录-聚合酶链反应（qRT-PCR）方法检测标本中CK-19的表达水平,并进行相关性分析。结果：VEGF在乳腺癌患者血清中的表达水平明显高于乳腺纤维腺瘤患者,二者差异显著（P=0.012）;在HER2阳性患者中,血清VEGF水平明显高于HER2阴性患者（P=0.016）。CK19在乳腺纤维腺瘤患者骨髓标本中未见表达,在乳腺癌患者骨髓血中,阳性表达24例（37.5%）,而骨髓中CK19阳性的乳腺癌患者血清VEGF水平显著高于CK19阴性的患者（110.46±90.65 vs 70.88±77.13,P=0.038）,且二者的表达呈正相关。结论：早期乳腺癌患者血清VEGF水平与骨髓微转移密切相关,提示VEGF可能参与了肿瘤细胞的侵袭和播散,可作为早期乳腺癌微转移的血清学指标。

Levels of serum VEGF in early breast cancer and its association with bone marrow micrometastases

Objective：To explore the levels of serum VEGF in early breast cancer and its clinical significance as well as the relationship with bone marrow micrometastases in the patients.Methods： Levels of serum VEGF in 6 cases of breast fibroadenoma and 64 cases of breast cancer were detected by ELISA.Bone marrow CK19 mRNA was detected by qRT-PCR as an index of micrometastases in the patients as well.Correlation between serum VEGF level and bone marrow micrometastasis was analyzed.Results： Levels of serum VEGF in breast cancer were significantly higher compared with those in breast fibroadenoma（P=0.012）.A subgroup analysis showed that in HER-2 positive patients,levels of serumVEGF were higher（P=0.016）.CK19 mRNA was found in bone marrow of 24 cases of breast cancer and the positive rate was 37.5%.However,it was not detected in the patients with breast fibroadenoma.Mean level of serum VEGF in CK19 positive and negative patients was 110.46±90.65 pg/ml and 70.88±77.13pg/ml,respectively.There was a significant difference between the two groups（P=0.038）.Conclusion： Levels of serum VEGF in early breast cancer was closely related with the bone marrow micrometastases.High level of serum VEGF may be a soluble biomarker for the early micrometastasis of breast cancer.