循环肿瘤细胞的HER2分型对转移性乳腺癌患者预后的影响研究

Prognostic significance of HER2 classification of circulating tumor cells in patients with metastatic breast cancer

目的:利用循环肿瘤细胞(circulating tumor cell,CTC)评估转移性乳腺癌(metastatic breast cancer,MBC)患者的人类表皮生长因子受体2(human epidermal growth factor 2,HER2)的表达水平,为下一步的治疗提供依据。方法:选取CTC阳性的MBC患者100例。采用免疫荧光染色检测CTC的HER2的表达,采用免疫组化染色检测原发肿瘤(primary,PRIM)和转移性肿瘤组织(metastatic,MET)的HER2的表达,并对两者进行生存分析比较。结果:100例患者中CTC-HER2阳性率为37%(37/100),其中8例为PRIM-HER2阳性。CTC-HER2阳性患者的无进展生存期显著长于CTC-HER2阴性患者(P<0.01),但总体生存期两者无显著性差异。结论:乳腺癌的疾病进展中HER2的状态是改变的。对CTC进行检测可以作为一种简单易行的方法来评估HER2的水平,对乳腺癌的临床治疗有潜在的指导作用。

Objective： To evaluate the expression levels of human epidermal growth factor receptor 2 （HER2） in patients with metastatic breast cancer （MBC） by circulating tumor cells （CTC） technology assessment,and to provide the basis for the next treatment.Methods. A total of 100 patients with CTC positive MBC were selected. The expression of CTCs HER2 was detected by immunofluorescence staining, the primary tumor and metastatic of HER2 were detected by immunohistochemical staining,and the survival of the two was compared.Results： The positive rate of CTC--HER2 was 37% （37/100）,8 of which were positive for PRIM-- HER2.The progression free survival time in CTC--HER2 positive patients was significantly longer than that in CTC--HER2 negative patients （P〈0.01）, but there was no significant difference in overall survival between the two groups.Conclusion： The status of HER2 may be altered in the progression of breast cancer.The detection of CTC can be used as a simplemethod to assess the level of HER2,and has a potential guiding role in the clinical treatment of breast cancer.