晚期转移性乳腺癌患者血液循环肿瘤细胞检测及其临床意义
首发时间:2014-01-28
摘要:[目的] 检测转移性乳腺癌患者外周血循环肿瘤细胞,分析其与临床疗效和预后的相关性。[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EPCAM的表达,分析其与临床疗效和生存期的关系。[结果] 共检测了42例转移复发性乳腺癌患者外周血CK19和EPCAM的表达,其中33例(78.6%)CK19阳性。16例(38.1%)EPCAM阳性,且均同时检测为CK19阳性。CK19和EPCAM检测阳性与化疗客观有效率(ORR)无关(p=0.65和0.93)。CK19和EPCAM阳性患者中位无进展生存期(PFS)分别为7.6±1.2个月和9.9±3.8个月,与CK19和EPCAM阴性组无统计学差异(p=0.84,p=0.38)。CK19和EPCAM阳性组总生存(OS)分别为26.2±1.2个月和26.0±2.1个月,与对照CK19和EPCAM阴性组也无统计学差异(p=0.23,p=0.23)。在33例CK(+)患者,化疗后CK19(+)值下降8例患者OS为26.2±1.2个月,而CK19值无变化或升高患者OS仅为23.7±1.4个月,两组间存在明显差异(p=0.025)。[结论]转移性乳腺癌患者外周血中存在CK19和EPCAM阳性循环肿瘤细胞,CK19阳性患者化疗后CK19水平下降提示预后较好,总生存期延长。
关键词: 乳腺癌 循环肿瘤细胞 细胞角蛋白19 上皮黏附分子
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The detection of circulating tumor cells in peripheral blood of metastatic breast cancer patients and its clinical impact
Abstract:[Object] To detect the circulating cancer cells (CTC) in peripheral blood of patients with metastatic breast cancer and analyze the relationship of it with clinical response and survival. [Methods] The expression of CK19 and EPCAM in 5 ml peripheral blood of patients was detected by quantitative real-time PCR. And the expression of CK19 and EPCAM was analyzed with the objective response rate (ORR) of chemotherapy and survival. [Results] Totally 42 breast cancer patients with metastatic disease were enrolled in this study. The CK19 was expressed in 33 of 42 (78.6%) patients. The EPCAM was expressed in 16 of 42 (38.1%) patients which were all with CK19 expression. The expression of CK19 and EPCAM had no relation with the ORR(p=0.65和0.93). The progression-free survival (PFS) of CK19(+) and EPCAM(+) patients were7.6±1.2 months and 9.9±3.8 months respectively and had no statistic difference compared with CK19(-) and EPCAM(-) group(p=0.84,p=0.38). The overall survival (OS) of CK19(+) and EPCAM(+) group were 26.2±1.2 months and 26.0±2.1 months respectively and had no statistic difference compared with CK19(-) and EPCAM(-) group(p=0.23,p=0.23). In CK19(+) population, the overall survival (OS)in 8 CK19 decreased patients after chemotherapy was 26.2±1.2 months while that in CK19 increasd patients was 23.7±1.4 months. There was significant difference(p=0.025)。[Conclusion] The expression of CK19(+) and EPCAM(+) circulating tumor cells were detectable in peripheral blood of metastatic breast cancer patients. Patients with decreased level of CK19(+) after chemotherapy had better prognosis and longer overall survival.
Keywords: Breast Cancer Circulating Tumor Cells Cytokeratin 19 Epithelial Cell Adhesion Molecule
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晚期转移性乳腺癌患者血液循环肿瘤细胞检测及其临床意义
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