乳腺癌外周血循环肿瘤细胞变化与新辅助化疗效果.docVIP

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4组，以RECIST标准评估NCT疗效时，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标准评估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 of peripheral blood circulating tumor cells with therapeutic effect of neoadjuvant chemotherapy in breast cancer: report of 70 cases Wang Minghao, Yang Xinhua, Zhang Yi, Fan Linjun, Zhang Fan, Qi Xiaowei, Li Shichao, Sun Peng, Jiang Jun (Center of Breast Diseases, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China) [Abstract] Objective To investigate the relationship between the alterations of circulating tumor cells (CTC) in peripheral blood and the curative effect of neoadjuvant chemotherapy for breast cancer. Methods A total of 70 patients with confirmed lateral breast infiltrating ductal carcinoma without obvious metastasis hospitalized in our department from March 2010to September 2011 were enrolled in this study. Venous blood samples of 5 ml were collected from their upper limb of health side before and after 2 to 6 cycles of TE regimen as neoadjuvant chemotherapy (paclitaxel 175 mg/m2, epirubicin 60 mg/m2, d1, 21 d/cycle). Density gradient centrifugation was used to enrich mononuclear cells in blood specimens. Fluorescence quantitative RT-PCR was used to detect the mononuclear cells positive to cytokeratin-19 (CK-19). Results Before neoadjuvant chemotherapy, 24.29% patients (17/70) had CTC detected, which was related