目的:探讨乳腺癌患者术前循环肿瘤细胞(CTCs)检测与术后临床病理特征的关系,研究其临床应用价值.方法:采用免疫磁珠阴性富集联合免疫荧光染色法检测60例乳腺良性结节患者及136例乳腺癌患者术前外周血CTCs水平,分析CTCs与患者临床病理特征的关系.结果:136例乳腺癌患者CTCs总阳性率为46.32％,在乳腺良性结节患者中未检出(P＜0.01).乳腺癌CTCs阳性率在年龄、肿瘤大小、Grade分级、淋巴结转移、AJCC分期、ER、PR、Ki67状态、分子分型表达差异均无统计学意义(P＞0.05).Her2阳性组低于Her2阴性组(36.2％ vs 51.7％),但差异无统计学意义.多因素分析表明CTCs阳性水平与AJCC分期及Her2状态具有相关性(P=0.011及P=0.057).结论:乳腺癌术前CTCs表达阳性率与术后病理AJCC分期及Her2状态相关,术前检测对病情评估有一定的临床应用价值.%Objective:To explore the relationship between the presence of circulating tumor cells(CTCs) before operation and the clinicopathologic characteristics after operation in breast cancer patients and study the clinical value.Methods:136 cases of patients with breast cancer and 60 cases of patients with benign nodule were chosen before operation,then those CTCs were collected based on negative immunomagnetic separation and then dectected by imFISH method in order to analyze the relationship between the positive rate of CTCs and clinicopathologic characteristics.Results:CTCs were detected in 46.32％ of breast cancer,and in 0 of benign nodule (P ＜ 0.01).The CTCs positive rates in breast cancer patients showed no significant difference among age,tumor size,histological grade,lymph node metastasis,AJCC stage,ER status,PR status,Ki67 status or molecular types(P ＞ 0.05).Her2 positive breast cancer detected less CTCs than Her2 negative breast cancer,although this difference as measured was not significant(P ＞0.05).Multivariate analysis showed CTCs enumeration and AJCC stage,Her2 status were relevant(P =0.011 and P =0.057).Conclusion:AJCC stage and Her2 status are the primary tumor characteristic that correlates with the presence of CTCs in breast cancer patients before operation,and CTCs detection before operation in breast cancer patients has great clinical value.
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