乳腺癌患者外周血中循环肿瘤细胞的检测及临床意义

Detection and Clinical Significance of Circulating Tumor Cell in Peripheral Blood of Patients With Breast Cancer

目的探讨乳腺癌患者外周血中循环肿瘤细胞(circulating tumor cells,CTC)的检测及临床意义。方法选取福建省漳州市医院乳腺外科2020年12月—2022年12月收治的200例乳腺癌患者纳入研究,并选择同期在福建省漳州市医院乳腺外科接受手术的40例良性乳腺病进行对照研究,采用纳米基底富集分离及免疫荧光原位杂交技术检测两组CTC检测阳性率,检测CTC人类表皮生长因子受体2(human epidermal growth factor receptor 2,Her2)表达,分析CTC与临床病理特征的关系。结果200例乳腺癌组织中,CTC阳性130例,占比65.00%;40例乳腺良性组织未检测到CTC,两组比较差异有统计学意义(P<0.05);乳腺癌患者阳性检测与血管侵犯有关(P<0.05);而与年龄、肿瘤大小、病理类型、雌激素受体(estrogen receptor,ER)和孕激素受体(progesterone receptor,PR)、淋巴结转移等均无相关(P>0.05);130例CTC阳性检查出95例Her2阳性。外周血检查出CTC存在Her2阳性有80例,两者比较一致性为84.21%(80/95)。结论外周血CTC与乳腺癌肿瘤发生远处转移存在一定关联,有助于评估乳腺癌患者的病情;CTC Her2检测可能有助于实时判断Her2的状态,对预后有重要意义。

Objective To investigate the detection and clinical significance of circulating tumor cells(CTC)in peripheral blood of patients with breast cancer.Methods A total of 200 patients with breast cancer admitted to the department of breast surgery,Zhangzhou Municipal Hospital of Fujian Province from December 2020 to December 2022 were included in the study,and 40 patients with benign breast disease who underwent surgery in the department of breast surgery,Zhangzhou Municipal Hospital of Fujian Province during the same period were selected for control study.Nano substrate enrichment and in situ immunofluorescence hybridization techniques were used to detect the positive rate of CTC in the two groups,the expression of human epidermal growth factor receptor 2(Her2)was detected,and the relationship between CTC and clinicopathological characteristics were analyzed.Results Among 200 breast cancer tissues,130 cases were CTC-positive,accounting for 65.00%.CTC was not detected in 40 benign breast tissues,and the difference between the two groups was statistically significant(P<0.05).The positive detection of breast cancer patients was associated with vascular invasion(P<0.05).There was no correlation with age,tumor size,pathological type,estrogen receptor(ER)and progesterone receptor(PR),lymph node metastasis(P>0.05).Of 130 CTC-positive cases,95 were Her2 positive.There were 80 cases of Her2 positive CTC in peripheral blood examination,and the consistency between the two was 84.21%(80/95).Conclusion Peripheral blood CTC are associated with distant metastasis of breast cancer tumors,which is helpful to evaluate the condition of breast cancer patients.CTC-Her2 detection may help to determine the status of Her2 in real time,which is of great significance for prognosis.