可手术乳腺癌患者的循环肿瘤细胞与凝血功能及病理特征的关系研究

Study on the Relationship between Circulating Tumor Cells and Coagulation Function and Pathological Characteristics in Patients with Operable Breast Cancer

目的:探讨可手术乳腺癌患者的循环肿瘤细胞(CTCs)与凝血功能及病理特征的关系。方法:选取本院2017年7月-2018年6月收治的56例可手术乳腺癌患者为研究对象,采集患者外周血检测CTCs,依据检测结果分为CTCs阴性组及CTCs阳性组,对比两组患者凝血功能指标[抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体(D-D)、纤维蛋白原(FIB)、血小板(PLT)]及病理特征[肿瘤大小、病理类型、肿瘤TNM分期、淋巴转移、病理学分级、人类表皮生长因子受体-2(Her-2)状态、孕激素受体(PR)状态、雌激素受体(ER)状态]差异。结果:56例可手术乳腺癌患者,CTCs阳性检出率14.29%。两组FIB、D-D水平比较,差异均无统计学意义(P>0.05)。阳性组患者AT-Ⅲ水平及PLT计数分别高于阴性组,差异有统计学意义(P<0.05)。可手术乳腺癌患者CTCs阳性率与肿瘤直径≥5 cm及Her-2状态有关(P<0.05),与病理类型、肿瘤TNM分期、淋巴转移、病理学分级、ER状态、PR状态无关(P>0.05)。结论:可手术乳腺癌患者外周血CTCs与Her-2状态有关,CTCs监测可能为评估此类患者术后静脉栓塞发生的有效方法。

Objective:To investigate the relationship between circulating tumor cells(CTCs)and coagulation function and pathological features in patients with operable breast cancer.Method:Fifty-six patients with operable breast cancer admitted to our hospital from July 2017 to June 2018 were included as the study subjects.Peripheral blood samples were collected to detect CTCs.According to the results,the patients were divided into CTCs negative group and CTCs positive group.The differences of coagulation function[antithrombinⅢ(AT-Ⅲ),D-dimer(D-D),fibrinogen(FIB),platelet(PLT)]and pathological characteristics[tumor size,pathological type,TNM stage,lymphatic metastasis,pathological grade,human epidermal growth factor receptor-2(Her-2),progesterone receptor(PR)and estrogen receptor(ER)status]between the two groups were compared.Result:The positive rate of CTCs was 14.29%in 56 patients with operable breast cancer.There was no significant difference in FIB and D-D between the two groups(P>0.05).The levels of AT-Ⅲand PLT in the positive group were higher than those in the negative group,and the difference was statistically significant(P<0.05).Tumor diameter≥5 cm and Her-2 status were associated with the positive rate of CTCs in patients with operable breast cancer(P<0.05).The positive rate of CTCs in operable breast cancer patients was not related to tumor size,pathological type,TNM stage,lymphatic metastasis,pathological grade,ER status and PR status(P>0.05).Conclusion:Peripheral blood CTCs in patients with operable breast cancer are associated with Her-2 status,and monitoring of CTCs may be an effective method for assessing postoperative venous thrombosis in such patients.