转移性乳腺癌循环肿瘤细胞检测对化疗疗效的评价

Application of circulating tumor cells detection in chemotherapeutic efficacy evaluation of metastatic breast cancer

目的 循环肿瘤细胞（circulating tumor cells,CTC）是指进入人体外周血的肿瘤细胞。本研究拟探讨CTC检测在转移性乳腺癌（metastatic breast cancer,MBC）化疗疗效评价中的应用价值。方法 2007-10-01-2010-06-30苏州大学附属第一医院收治136例MBC患者,患者每3个化疗周期做一次CT检查,参照实体瘤评价标准（response evaluation criteria in solid tumors,RECIST）评价病情。评价当天采集7.5 mL外周血,应用膜滤过（isolation by size of epithelial tumor cells,ISET）结合激光扫描细胞术（laser scanning cytometry,LSC）检测CTC,CTC水平以肿瘤细胞检出数/7.5mL血表示。结果 136例MBC患者共完成341次CTC检测,其中262个（76.83%）血标本可检测到CTC,平均检出CTC数量为（6.73±4.92）个/7.5 mL样本。136例MBC患者治疗后达到完全或部分缓解43例（31.62%）,稳定39例（28.67%）,无效进展54例（39.71%）。患者病程中CTC数目的改变,与病情的转归显著相关,r=0.514 83,P〈0.01;化疗后CTC数目不变或下降的病例,预后较好,化疗后CTC数目上升的病例预后差。治疗前的CTC水平与疾病转归无明显相关性,χ^23.62,P=0.082 15。结论 CTC检测可用于MBC患者化疗后疗效评价。

OBJECTIVE To investigate the application of circulating tumor cells （CTC） detection in chemotherapeutic efficacy evaluation in metastatic breast cancer（MBC）. METHODS 136 patients were enrolled in this study. The tumors were monitored by computed tomography every 3 chemotherapy cycles and evaluated according to Response Evaluation Criteria in Solid Tumors （RECIST）. In the mean time, the levels of CTCs were monitored using cell filtration （isolation by size of epithelial tumor cells, ISET） together with laser scanning cytometry （LSC）. RESULTS Among the 341 samples collected from 136 patients, CTC could be found in 262 specimens （76. 83%）, and the mean number of CTC was （6.73±4.92）/7.5 mL blood. Among the 136 patients, 43 cases achieved complete or partial remission （31.62%）. 39 cases remained stable （28.67%）. And 54 cases were progressive （39.71%）. Changes in CTC numbers were significantly associated with the disease progresses after chemotherapy （r=0. 514 83, P〈0.01）. However, CTC baseline level did not predict response to treatment （X2 = 3.62,P= 0. 08215）. CONCLUSION C TC detection could be used in the efficacy evaluation of chemotherapy in MBC.