乳腺癌患者CTCs、ctDNA检测及其诊断价值研究

Detection of CTCs and ctDNA in breast cancer patients and its diagnostic value

目的探讨乳腺癌患者的循环肿瘤细胞(CTCs)、循环肿瘤细胞DNA (ctDNA)检测水平及其诊断价值,为患者的临床诊断提供指导。方法选取2017年1月至2019年1月西北大学附属医院收治的60例乳腺癌患者作为观察组,同期体检健康者50例作为对照组。采集两组受检者的外周血实施CTCs及ctDNA检测,比较观察组不同特征患者及对照组的CTCs阳性率与ctDNA水平。结果观察组患者的CTCs阳性率为38.33%(23/60),ctDNA水平为(152.6±12.4) ng/mL;对照组CTCs均为阴性,ctDNA水平为(28.1±4.3) ng/mL,观察组CTCs阳性率与ctDNA水平明显高于对照组,差异均有统计学意义(P<0.05);不同年龄与病理类型乳腺癌患者的CTCs阳性率与ctDNA水平比较差异均无统计学意义(P>0.05);TNM分期Ⅰ期患者的CTCs阳性率为0,ctDNA水平为(110.2±8.6) ng/mL,TNM分期Ⅱ期患者的CTCs阳性率为25.00%,ctDNA水平为(143.6±10.2) ng/mL,TNM分期Ⅲ期患者的CTCs阳性率为51.43%,ctDNA水平为(168.9±8.5) ng/mL,不同乳腺癌TNM分期患者CTCs阳性率与ctDNA水平比较差异均有统计学意义(P<0.05);M0期患者的CTCs阳性率为12.50%,ctDNA水平为(125.8±8.9) ng/mL,M1期患者的CTCs阳性率为90.00%,ctDNA水平为(176.5±10.8) ng/mL,不同乳腺癌M分期患者CTCs阳性率与ctDNA水平比较差异均具有统计学意义(P<0.05)。结论乳腺癌患者CTCs、ctDNA检测可为患者的临床诊断提供指导。

Objective To explore the detection and diagnostic value of circulating tumor cells(CTCs) and circulating tumor cell DNA(ctDNA) in breast cancer patients, and to provide guidance for clinical diagnosis of patients.Methods A total of 60 patients with breast cancer, who admitted to the Affiliated Hospital of Northwest University from January 2017 to January 2019, were selected as the observation group. During the same period, 50 personnel of routine physical examination in our hospital were enrolled as the control group. The peripheral blood samples of the two groups were collected for CTCs and ctDNA detection, and the positive rates of CTCs and ctDNA level of the patients with different characteristics in the observation group and the control group were compared. Results The positive rate of CTCs in the observation group was 38.33%(23/60), and the level of ctDNA was(152.6±12.4) ng/mL;the CTCs in the control group were all negative, and the level of ctDNA was(28.1±4.3) ng/mL, the positive rate of CTCS and ctDNA in the observation group were significantly higher than those in the control group(P<0.05);there was no significant difference in CTCs positive rate and the level of ctDNA between breast cancer patients of different ages and pathological types(P>0.05). The positive rate of CTCs in patients with TNM stage Ⅰwas 0 and the level of ctDNA was(110.2±8.6) ng/mL;the positive rate of CTCs in patients with TNM stageⅡwas 25.00% and the level of ctDNA was(143.6±10.2) ng/mL;the positive rate of CTCs in patients with TNM stage Ⅲ was 51.43%, and the level of ctDNA was(168.9±8.5) ng/mL;there was statistically significant difference in the positive rate of CTCs between patients with different breast cancer TNM stages and ctDNA levels(P<0.05). The positive rate of CTCs in M0 patients was 12.50%,and the ctDNA level was(125.8±8.9) ng/mL;the positive rate of CTCs in M1 patients was 90.00%, and the level of ctDNAwas(176.5 ± 10.8) ng/mL;the difference of CTCS positive rate and ctDNA level in different breast cancer M stages was statistically significant(P<0.05). Conclusion The detection of CTCs and ctDNA in breast cancer patients can provide guidance for clinical diagnosis of patients.