CTC、HER2及PI3KCA在转移性乳腺癌中的表达

Expression of CTC,HER2 and PI3KCA in metastatic breast cancer

目的探讨循环肿瘤细胞(CTC)以及人类表皮生长因子受体2(HER2)、磷脂酰肌醇-3-激酶催化亚单位α(PI3KCA)在转移性乳腺癌中的表达意义。方法选取江苏省南通市中医院(以下简称“我院”)2018年4月—2019年6月收治的转移性乳腺癌患者50例作为病例组,选取同期于我院体检的健康妇女50名作为正常组。所有纳入者于就诊/体检当日采集空腹静脉血,分别测定并比较两组CTC、HER2、CF-DNA中PI3KCA含量及血清癌胚抗原(CEA)、糖类抗原15-3(CA15-3)水平,采用Kappa检验分析CTC、HER2及CF-DNA中PI3KCA含量诊断转移性乳腺癌与病理诊断的一致性,并采用Pearson线性模型分析CTC、HER2、CF-DNA中PI3KCA含量与血清CEA、CA15-3水平的相关性。结果病例组CTC、HER2及CF-DNA中PI3KCA含量均高于正常组,差异有统计学意义(P<0.05),三者联合诊断转移性乳腺癌的灵敏度为86.00%,特异度为90.00%,准确率为88.00%,阳性预测值为89.58%,阴性预测值为86.54%,与病理诊断一致性为0.760(高度一致)。病例组血清CEA、CA15-3含量显著高于正常组(P<0.05)。Pearson分析提示CTC、HER2蛋白量、CF-DNA中的PI3KCA短片段含量与血清CEA、CA15-3呈正相关(r=0.752、0.801;0.691、0.702;0.628、0.611,均P<0.05)。结论转移性乳腺癌者的CTC、HER2及CF-DNA中PI3KCA含量与血清CEA、CA15-3水平均具有相关性,且对转移性乳腺癌具有较高诊断价值,与病理诊断一致性较好。

Objective To explore the expression of circulating tumor cell(CTC),human epidermal growth factor receptor 2(HER2),phosphatidylinositol-3-kinase catalytic subunitα(PI3KCA)in metastatic breast cancer.Methods A total of 50 cases of metastatic breast cancer patients in Nantong Hospital of Traditional Chinese Medicine(“our hospital”for short)from April 2018 to June 2019 were selected as the case group,and 50 cases of healthy women in our hospital during the same period were selected as the normal group.The levels of CTC,HER2,PI3KCA in CF-DNA and serum levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 15-3(CA15-3)were measured and compared between the two groups.Kappa test was used to analyze the consistency of CTC,HER2 and PI3KCA content in CF-DNA in diagnosis of metastatic breast cancer and pathological diagnosis.Pearson linear model was used to analyze the correlation between CTC,HER2,PI3KCA content in CF-DNA and serum CEA,CA15-3 levels.Results The levels of CTC,HER2 and PI3KCA content in CF-DNA in the case group were higher than those in the normal group(P<0.05).The sensitivity of the three combined diagnosis of metastatic breast cancer was 86.00%,the specificity was 90.00%,the accuracy rate was 88.00%,the positive predictive value was 89.58%,the negative predictive value was 86.54%,and the consistency with the pathological diagnosis was 0.760(highly consistent).The serum CEA and CA15-3 levels in the case group were significantly higher than those in the normal group(P<0.05).Pearson analysis showed that the number of CTC,the amount of HER2 protein and the content of PI3KCA short fragment in CF-DNA were positively correlated with CEA and CA15-3 in serum(r=0.752,0.801;0.691,0.702;0.628,0.611,all P<0.05).Conclusion The contents of CTC,HER2 and PI3KCA in CF-DNA in patients with metastatic breast cancer are correlated with serum CEA and CA15-3 levels,and have high diagnostic value for metastatic breast cancer,and have good consistency with pathological diagnosis.