乳腺癌循环肿瘤细胞检测的临床价值

Clinical value of detection of circulating tumor cells in breast cancer

目的探讨乳腺癌循环肿瘤细胞(CTC)检测的临床意义。方法选取2016年5月至2018年4月南宁市第二人民医院乳腺甲状腺外科收治的111例乳腺癌确诊患者为研究对象,比较不同TNM分期患者CTC阳性率差异、乳腺癌术后患者化疗前后CTC阳性率差异、CTC阳性与阴性患者的化疗效果。结果Ⅰ期患者CTC阳性率为12.5%(2/16)、Ⅱ期患者阳性率为68.1%(47/69)、Ⅲ期患者阳性率为90.9%(20/22)、Ⅳ期患者阳性率为100.0%(4/4),四组患者间的CTC阳性率比较差异具有显著统计学意义(P<0.01);化疗(或内分泌治疗)前CTC检出阳性率为65.8%(73/111),显著高于化疗(或内分泌治疗)后的32.4%(36/111),差异具有显著统计学意义(P<0.01);化疗(或内分泌治疗)前CTC阳性与阴性两组患者化疗有效率比较,化疗(或内分泌治疗)前CTC检测为阳性患者有效率为30.1%,显著低于化疗(或内分泌治疗)前CTC检测为阴性患者的68.4%,差异具有显著统计学意义(P<0.01)。结论 CTC检测可作为乳腺癌的独立生物学因素,有助于全面病情评估、复发及转移的早期定位,而化疗后CTC阳性率显著下降,可有效预测乳腺癌辅助治疗的疗效与预后。

Objective To discuss the clinical significance of detection of circulating tumor cells （CTC） in breast cancer. Methods A total of Ⅲ confirmed breast cancer patients admitted to the Department of Breast and Thyroid Surgery at the Second Nanning People＇s Hospital during May 2016 and April 2018 were selected as subjects. Differences were compared including the CTC positive rates among patients with different TNM stages, CTC positive rates before and after chemotherapy in patients with breast cancer, and chemotherapeutic effects in patients with positive or negative CTC. Results The positive rate of CTC was 12.5% （2/16） in stage Ⅰ, 68.1% （47/69） in stage Ⅱ, 90.9% （20/22） in stage Ⅱ, and 100.0% （4/4） in stage IV; the differences of CTC positive rate among the four groups of patients were statistically significant （P〈0.01）. The positive rate of CTC detection before chemotherapy （or endocrine therapy） was 65.8% （73/111）, which was significantly higher than 32.4% （36/111） after chemotherapy （or endocrine therapy）; the difference was statistically significant （P〈0.01）. The efficiency of CTC positive and negative patients before chemotherapy （or endocrine therapy） was compared. The effective rate of CTC test positive before chemotherapy （or endocrine therapy） was 30.1%, significantly lower than 68.4% in patients with negative CTC test before chemotherapy （or endocrine therapy） （P〈0.01）. Conclusion CTC detection can be used as an independent biological factor for breast cancer, which is helpful for overall disease assessment and early location of recurrence and metastasis. The positive rate of CTC after chemotherapy is significantly decreased, which can effectively predict the efficacy and prognosis of adjuvant therapy for breast cancer. It is worthy of clinical promotion.