乳腺癌患者外周血中循环肿瘤细胞和外泌体的表达及其临床意义

Detection of circulating tumor cells and exocrine bodies in peripheral blood of breast cancer and its clinical significance

目的探讨循环肿瘤细胞(CTCs)和外泌体在乳腺癌患者外周血中的表达情况及其临床意义。方法收集87例乳腺癌患者、40例乳腺良性肿瘤患者及20例健康体检者外周血,采用Cell search系统检测外周血中CTCs,实时荧光定量聚合酶链反应(qRT-PCR)检测microRNA-1246(miR-1246)的表达。结果乳腺癌患者外周血中CTCs为(4.36±1.08)个/ml,高于良性乳腺肿瘤患者和健康体检者(P<0.05);乳腺癌患者外周血中miR-1246相对表达水平为(102.94±43.28),高于良性乳腺肿瘤患者与健康体检者外周血miR-1246(P<0.05)。外周血中CTCs诊断乳腺癌的符合率为68.9%,miR-1246的诊断符合率为63.2%;CTCs联合miR-1246诊断乳腺癌的符合率为81.6%,3组间诊断符合率比较差异有统计学意义(P<0.05)。以病理活检为金标准,外周血CTCs和miR-1246单独诊断乳腺癌的κ值均<0.4(一致性较差);两者联合诊断乳腺癌κ值为0.46(具有较好的一致性)。结论外周血中CTCs与miR-1246联合检测有助于早期发现乳腺癌,为乳腺癌的个性化检测和治疗提供方向。

Objective To investigate the expression and clinical significance of circulating tumor cells(CTCs)and exosomes in peripheral blood of patients with breast cancer.Methods Peripheral blood of 87 patients with breast cancer,40 patients with benign breast tumor and 20 healthy controls were collected.CTCs in peripheral blood were detected by Cell search system.The expression of microRNA-1246 was detected by quantitative realtime polymerase chain reaction(qRT-PCR).Results The number of CTCs in peripheral blood of breast cancer patients was(4.36±1.08)/ml,which was higher than that of benign breast cancer patients and healthy control group(P<0.05).The relative expression level of miR-1246 in peripheral blood of breast cancer patients(102.94±43.28)was higher than that of benign breast cancer patients and healthy control group(P<0.05).The coincidence rate of CTCs in diagnosis of breast cancer in peripheral blood(68.9%)was higher than that of microRNA-1246(63.2%)(P>0.05);the coincidence rate of CTCs combined with microRNA-1246 in diagnosis of breast cancer was 81.6%.There was significant difference among the three methods(P<0.05).According to the gold standard of pathological biopsy,the consistency of blood CTCs and miR-1246 in diagnosis of breast cancer was evaluated by Kappa test.Theκvalues were<0.4,indicating poor consistency.Theκvalue of peripheral blood CTCs combined with miR-1246 in diagnosis of breast cancer was 0.46,indicating good consistency.Conclusions The combined detection of CTCs and microRNA-1246 in peripheral blood is helpful for early detection of breast cancer and provides a direction for individualized detection and treatment of breast cancer.