乳腺癌外周血循环肿瘤细胞变化与新辅助化疗效果的关系.doc

乳腺癌外周血循环肿瘤细胞变化与新辅助化疗效果的关系 王明浩，杨新华，张 毅，范林军，张 帆，齐晓伟，李世超，孙 鹏，姜 军（400038 重庆，第三军医大学西南医院乳腺中心） [摘要] 目的 探讨乳腺癌患者外周血中循环肿瘤细胞（circulating tumor cell，CTC）变化情况与新辅助化疗（neoadjuvant or primary chemotherapy，NC）L，利用密度梯度离心法富集血标本中单个核细胞，通过荧光定量RT-PCR技术检测所获得单个核细胞中细胞角蛋白-19（cytokeratin -19，CK-19）阳性的CTC数目。 结果 NCT前外周血CTC检出率为24.29%（17/70），与患者年龄（P=0.008）及HER-2（P=0.022）表达情况有关。根据NCT前后CTC检测情况，将患者分为阳性-阳性、阳性-阴性、阴性-阳性及阴性-阴性等4组，以RECIST标准评估NCT时，4组有效率依次为66.67%（2/3）、78.57%（11/14）、0（0/4）和71.43%（35/49），差异具有统计学意义（P=0.023）；以Miller-Payne标准NCT疗效时，4组有效率依次为66.67%（2/3）、71.43%（10/14）、0（0/4）和69.39%（34/49），差异具有统计学意义（P=0.043）。结论 NCT前后CTC的变化情况与疗效有一定关系，CTC可作为评估NCT疗效的潜在预测指标。 [关键词] 乳腺肿瘤；新辅助化疗；循环肿瘤细胞 [中图法分类号] [文献标志码] A Relationship between the change of peripheral blood circulating tumor cell and neoadjuvant chemotherapy curative effect in breast cancer Wang Minghao, Sun Peng, Yang Xinhua, Zhang Yi, Fan Linjun, Zhang Fan, Qi Xiaowei, Li Shichao, Jiang Jun (Center of breast cancer, Southwest Hospital, Third Militray Medical Univarsity, Chongqing, 400038, China) [Abstract] Objective To investigate correlation between the change of circulating tumor cells(CTC) in peripheral blood and the curative effect of neoadjuvant chemotherapy with breast cancer patients. Methods Extract upper limb of health side venous blood 5ml from 70 patients with breast cancer who accept the neoadjuvant chemotherapy before and after, using density gradient centrifugation enrichment of mononuclear cell in blood specimens, mononuclear cells obtained by fluorescence quantitative RT-PCR to detect cell keratin-19(cytokeratin-19,CK-19) in the positive CTC. Results Neoadjuvant chemotherapy in patients with peripheral blood before the CTC detection rate was 24.29%(17/70), with age(P=0.008) and HER-2 expression(P=0.022) related. NCT of the patients before and after, CTC detection with positive-positive, positive-negative, negative-positive and negative-negative group, the RECIST criteria evaluation NCT, efficiency wer