血清游离HER-2在乳腺癌患者检测的临床意义

Value of Measuring Serum HER-2 Extracellular Domain in Patients with Breast Cancer

目的探讨乳腺癌患者血清HER-2水平与临床病理特征及化疗疗效的关系及临床意义。方法采用酶联免疫法(ELISA)检测40例晚期乳腺癌及30例早期乳腺癌血清HER-2的浓度,分析血清与组织中HER-2表达的相关性,探索血清中HER-2水平与年龄、月经状况、激素受体表达等临床病理特征的关系。结果在晚期乳腺癌患者中,化疗前血清HER-2的平均浓度28.09ng/ml(0.41～178.35ng/ml),血清HER-2水平与组织HER-2状态、转移部位、转移器官数目相关(P值分别为0.003,0.022,0.012)。治疗前血清HER-2浓度与化疗疗效无关。晚期复发乳腺癌患者化疗2周期后血清HER-2浓度较化疗前均有显著下降(P<0.001),与治疗疗效无关。但治疗有效组(CR+PR)较治疗无效组(SD+PD)血清HER-2下降幅度更大,有显著差异性(P=0.010)。在早期乳腺癌术后患者中,血清HER-2浓度与年龄、月经状况、ER、PR、组织HER-2、淋巴结转移、病理类型等均无明显关系。结论血清HER-2尚不能确立为独立的预后指标,需要更多的病例进行分析。

Objective To investigate the relationship between serum HER - 2 concentration and efficancy of chemotherapy, and to analyze its clinical significance. Methods The serum HER - 2 protein levels of 40 advanced breast cancer patients before and after chemotherapy,and 30 primary breast cancer patients＇ after surgery in the oncology department of Chang Hal hospital were detected by ELISA method. The relationship between the protein level and patients＇clinical features,therapeutic response and prognosis were analyzed retrospectively. Results In advanced breast cancer, the mean serum HER - 2 concentration of advanced breast cancer patients before therapy was 28.09ng/ml （0.41 N 178.35ng/ml） ,and the level of serum HER -2 was concordance with strong expression of HER -2 in tumor tissue, the number and site of metastasis （ P - 0. 003,0. 022,0. 012）. There was no correlation between pre - therapy serum HER - 2 levels and therapeutic. The majority of patients demonstrated a decrease in HER -2 ECD regardless of response（ P 〈 0. 001 ） , but HER -2 ECD decreased to a greater degree among responders （CR ＋ PR） than nonresponders （SD ＋ PD ） （P = 0. 010 ）. The difference was of statific significance. In primary breast cancer patients, age, menstrual status, hormone receptor, HER -2, pathological subtype in tumor tissue wasn＇t in concordance with the level of serum HER - 2. Conclusion The clinical utility of serum HER - 2 as a prognostic indicator has not yet been established and needs more cases to evaluate.