乳腺癌骨髓微小转移的检测及其预后意义

Detection of Micrometastasis on Breast Cancer Patient and Its Prognostic Significance

采用免疫组化技术连续对我院８２例传统检查无远处转移且行手术治疗的乳腺癌患者，进行骨髓内上皮膜抗原（ＥＭＡ）和（或）角蛋白（ＫＴ）表达细胞的测定，６８例得到随访。结果发现，骨髓阳性患者２８例５年生存率仅为２５％，而４０例骨髓阴性患者高达８５％，两者差别明显（Ｐ＜０．００５）。此外，骨髓阳性与预后指标如腋淋巴结状态、临床分期有密切联系。研究表明，该方法判断乳腺癌预后敏感、特异、直接，是检测乳腺癌微小转移的好方法。同时该方法对术后综合治疗的选择有一定的指导意义。

This study was designed to investigate correlation between micrometastasis in bone marrow and prognosis of patients with breast cancer. Eighty-two consecutive patients with breast cancer in our hospital were included and evaluated. Immunohistochemical assay for the detection of epithelial membrane antigen (EMA) and (or) keratin (KT) expression cells in bone marrow was adopted to study micrometastasis. Sixtyeight cases were followed up more than 5 years. 21 patients (75%) with micrometastasis in bone died within 5 years after operation while only 6 cases (15%) free from micrometastasis died in the same time (P<0.005). The presence of bone marrow micrometastasis was closely related to some prognostic factors (e.g.axillary lymph nodes metastasis and tumor stages). The tumor cell detection in bone marrow of patients of breast cancer by immunohistochemical method is a kind of sensitive, specific and direct predictor for 5 year survival and can be used as one of the best ways detecting micrometastasis. The high predicting value may help in selecting patients for subsequent systematic treatment.