乳腺癌患者血浆EDA片段拷贝数变化的临床意义

Clinical Significance of Plasma Fibronectin EDA Fragment Copy Number in Patients with Breast Cancer

目的探讨血浆纤维连接蛋白EDA片段拷贝数变化在乳腺癌患者转移中的意义。方法选取98例接受手术的乳腺癌患者,同时选取100例病理为乳腺良性病的患者,乳腺癌患者在不同时段留取血浆标本,DNA提取采用Omega基因组DNA提取试剂盒,用AccuCopy TM多重基因拷贝数检测技术进行纤维连接蛋白EDA片段拷贝数检测。结果乳腺癌患者血浆标本EDA片段多拷贝显著高于良性患者(乳腺癌39.8%,乳腺良性病2.0%,P=0.000)。在治疗前后,乳腺癌患者外周血EDA片段多拷贝有明显变化(治疗前39.8%,治疗后18.4%,P=0.001)。随访5年,28例乳腺癌患者出现复发或转移,治疗前检测到EDA片段多拷贝的患者有较高的复发转移风险(检测到41.0%,未检测到20.3%,P=0.026)。随访过程中,血浆EDA多拷贝状态的变化也较好的反应了患者的预后(未检测到变为检测到的患者57.1%预后差,一直未检测到仅8.9%预后差,P=0.000;呈持续多拷贝状态的患者53.3%预后差,多拷贝变为未检测到的患者均预后好,P=0.004)。结论通过外周血浆EDA片段拷贝数检测,为乳腺癌辅助诊断及预后监测提供了一个可选择指标。

Objective To investigate the significance of the changes of plasma fibronectin EDA copy number in breast cancer patients with metastasis.Methods Totally 98 patients with breast cancer and 100 patients with benign breast cancer were selected.Plasma samples were collected from patients with breast cancer at different times.Omega genomic DNA extraction kit was used to extract genes,and AceuCopy TM multiple gene copy number detection technique was used to detect the copy number of fibronectin EDA fragments.Results Multiple copies of EDA fragments in plasma samples of breast cancer patients were significantly higher than those of benign patients(breast cancer 39.8%,breast benign diseases 2.0%,P=0.000).There were significant changes in multiple copies of EDA fragments in peripheral blood of breast cancer patients before and after treatment(39.8%before treatment and 18.4%after treatment).During the 5-year follow-up,28 breast cancer patients had recurrence or metastasis.Patients with multiple copies of EDA fragments detected before treatment had a higher risk of recurrence and metastasis(detected 41.0%,not detected 20.3%).During the follow-up,the change of plasma EDA multi-copy status also reflected the prognosis of patients(57.1%of the patients who had never been detected had a poor outcome,and only 8.9%of the patients had a poor outcome,pendant 0.014;53.3%of the patients with persistent multi-copy status had a poor outcome,and all the patients who changed from multiple copies to undetected patients had a good prognosis).Conclusion It is convenient and dynamic to detect the copy number of EDA fragments in peripheral plasma.Through this study,the copy number of fibronectin EDA fragment is shown that it can be used as an index for auxiliary diagnosis and prognosis of breast cancer.