循环肿瘤细胞与乳腺癌新辅助治疗疗效的关系

Clinical study on the relationship between circulating tumor cells and neoadjuvant therapy for breast cancer

目的分析循环肿瘤细胞(CTC)与乳腺癌新辅助治疗疗效间的关联性。方法选择2020年10月至2022年12月间入院治疗的79例接受新辅助治疗的乳腺癌患者,治疗前后抽取静脉血,测定血标本的单个核细胞,并测定细胞角蛋白-19(CK-19)阳性结果下的CTC数目。结果患者治疗前CTC阳性检出率26.6%(21/79),其阳性率与HER-2表达、TNM分期、KI-67百分比相关。新辅助治疗后的CTC阳性率8.9%(7/79)低于新辅助治疗前(χ^(2)=16.185,P<0.001)。结合新辅助治疗前后所测定的CTC结果,细分为阴性/阴性、阳性/阳性、阴性/阳性及阳性/阴性组,根据实体瘤疗效评价(RECIST)标准预测疗效,CTC阴性/阴性组75.0%(36/48)及阳性/阴性组83.3%(20/24)治疗有效率明显高于CTC阳性/阳性25.0%(1/4)及阴性/阳性0.0%(0/3)组(χ^(2)=13.886,P=0.003)。根据Miller-payne标准预测疗效,CTC阴性/阴性72.9%(35/48)组及阳性/阴性79.2%(19/24)组治疗有效率明显高于CTC阳性/阳性50.0%(2/4)及阴性/阳性0.0%(0/3)组(χ^(2)=9.043,P=0.029)。结论CTC水平和新辅助治疗疗效具有关联性,可将CTC视作新辅助治疗疗效的评价指标之一。

Objective To analyze the correlation between the level of circulating tumor cells(CTC)and the efficacy of neoadjuvant therapy in breast cancer.Methods A total of 79 patients with breast cancer who underwent neoadjuvant therapy between October 2020 and December 2022 were included in this study.Venous blood samples were collected before and after treatment to measure the number of mononuclear cells and the presence of cytokeratin-19(CK-19)positive circulating tumor cells(CTCs).Results The pre-treatment positive detection rate of CTC in patients was 26.6%(21/79),and it was found to be correlated with HER-2 expression,TNM staging,and KI-67 percentage.After neoadjuvant therapy,the positive rate of CTC decreased to 8.9%(7/79),which was lower than the rate before neoadjuvant therapy(χ^(2)=16.185,P<0.001).Based on the CTC results measured before and after neoadjuvant therapy,the groups were classified into negative/negative,positive/positive,negative/positive,and positive/negative groups.In accordance with the RECIST standard,the predicted efficacy was 75.0%(36/48)in the CTC negative/negative group and 83.3%(20/24)in the positive/negative group.The treatment effectiveness rate was notably higher compared to the CTC positive/positive group,which had a rate of 25.0%(1/4),and the negative/positive group,which had a rate of 0.0%(0/3)(χ^(2)=13.886,P=0.003).According to Miller Payne's standard for predicting efficacy,the treatment effectiveness rate in the CTC negative/negative group was 72.9%(35/48),while in the positive/negative group it was 79.2%(19/24).These rates were significantly higher than the rates in the CTC positive/positive group(50.0%,2/4)and the negative/positive group(0.0%,0/3).(χ^(2)=9.043,P=0.029).Conclusion There is a correlation between the level of circulating tumor cells(CTC)and the efficacy of neoadjuvant therapy.CTC can be considered as an evaluation indicator for assessing the efficacy of neoadjuvant therapy.