转移性乳腺癌患者血液循环肿瘤细胞HER2状态与组织标本存在明显差异
首发时间:2014-01-26
摘要:[目的] 检测转移性乳腺癌患者外周血循环中肿瘤细胞(CTC),探讨外周血中CTC的HER2表达与肿瘤组织标本的相关性。[方法] 采用实时定量荧光PCR方法检测乳腺癌患者5ml外周血中CK19和HER2的表达,分析CK19阳性乳腺癌患者外周血HER2表达与组织标本的相关性。[结果] 共检测了45例晚期转移性乳腺癌患者,其中32例患者CK19检测阳性,阳性率71.1%(32/45)。在32例CK19(+)患者中,CTC检测HER2阳性10例,阳性率31.3%(10/32)。组织标本HER2免疫组化检测为阳性(+++)6例,阳性率18.7%(6/32),但其外周血HER2检测均为阴性,表明CK19阳性CTC细胞HER2状态与组织标本存在明显差异(p=0.024)。外周血CK和HER2检测均阳性患者无进展生存期(PFS)5.1±2.1个月,而CK19和HER2检测均阴性患者PFS为7.4±4.1个月,两组间无显著性差异(p=0.67)。[结论] 转移复发性乳腺癌患者外周血中HER2检测与组织标本HER2检测结果存在较大差异,外周血检测到HER2阳性CTC不能代表组织标本HER2阳性,针对外周血HER2阳性CTC开展靶向治疗可行性需要进一步研究。?????
关键词: 乳腺癌 循环肿瘤细胞 人表皮生长因子受体2
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The HER2 status of circulating tumor cells in peripheral blood of metastatic breast cancer patients is discordance with that of tumor tissue
Abstract:[Object] To detect the HER2 status of circulating breast cancer cells (CTC) in peripheral blood of metastatic breast cancer patients and analyze the correlation with its expression on tumor tissue. [Methods] The expression of CK19 and HER2 in 5 ml peripheral blood of patients was detected by quantitative real-time PCR. The expression of HER2 in tumor tissue was detected by immunohistochemical staining. And the relationship of HER2 expression in CTC and tissue was analyzed. [Results] Totally 45 metastatic breast cancer patients were enrolled. The CK19 mRNA was detective in 32 patients with the positive rate of 71.1% (32/45). In these 32 CK19(+) samples, the expression of HER2 was detective in 10 samples with the HER2 positive rate of 31.3% (10/32). 6 of 32(18.7%) CK19(+) patients were with HER2 overexpression on tumor tissue, but all of them were with HER2 negative CTC (p=0.024), which suggested the discordance of HER2 status on CTC and tumor tissue. Patients with both CK19 and HER2 expression in peripheral blood had a shorten progression-free survival(PFS) compared with those without expression of CK19 and HER2 (5.1±2.1 months versus 7.4±4.1 months) but without statistical difference (p=0.67). [Conclusion] The HER2 status in CTC peripheral blood from metastatic breast cancer patients had no correlation with its expression in tumor tissue. The HER2(+) CTC might could not indicate HER2 overexpression of tumor tissue. Therefore, further studies should be undergone before inducing targeting treatment such as transtuzumab based on the HER2 status of CTC.
Keywords: Breast Cancer Circulating Tumor Cells Human Epithelial Growth Receptor 2
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转移性乳腺癌患者血液循环肿瘤细胞HER2状态与组织标本存在明显差异
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