转移性乳腺癌上皮特异性细胞粘附分子(EpCAM)mRNA阳性循环肿瘤细胞检测及其临床价值

摘要

Objective;To test for circulating tumor cells (CTCs) relying on epithelial cellular adhesion molecule (EpCAM) expression in metastatic breast cancer by quantitative real-time reverse transcription-PCR. Methods; In the study,47 metastatic breast cancer patients were evaluated by quantitative realtime PCR for detecting EpCAM mRNA. In addition, analyses were carried out for their correlation with patients' clinicopathologic features, response, and the time to progression (TTP). Results; The sensitivity of EpCAM mRNA in the metastatic breast cancer patients was about 40%. However, the specificity of EpCAM mRNA for 20 healthy controls was 100%. TTP was calculated, and compared with that between EpCAM mRNA-positive and EpCAM mRNA-negative groups. For the retrospective study, the median TTP was 7. 1 months and 11.1 months (P=0.013) for patients with EpCAM mRNA-positive and EpCAM mRNA-negative, respectively, after the first cycle chemotherapy. Moreover, a statistically significant correlation was demonstrated between EpCAM mRNA and TTP in patients who underwent the first or the second-line chemotherapy (P =0.018) , but there was no significance in the patients pretrea-ted with two or more previous chemotherapy lines (P =0.471 ). Conclusion; This study provides evidence of the presence of EpCAM mRNA in approximately 40% of patients with metastatic breast cancer. There is a strong correlation between EpCAM mRNA results after the first cycle therapy and TTP in metastatic breast cancer patients, and EpCAM mRNA positive after chemotherapy may predict shorter TTP.%目的:以上皮特异性细胞粘附分子(epithelial cellular adhesion molecule,EpCAM)为标志,用实时定量PCR的方法检测转移性乳腺癌循环肿瘤细胞(circulating tumor cells,CTCs).方法:以实时定量PCR的方法检测47例转移性乳腺癌患者及20例健康志愿者EpCAM mRNA的表达,并与原发灶病理特征、转移部位、疗效和疾病进展时间(time to progression,TTP)做相关分析.结果:化疗前和第1周期化疗后转移性乳腺癌患者的EpCAM mRNA阳性率分别37.8％和42.6％,20例健康志愿者均为阴性.转移性乳腺癌患者生存分析显示,第1周期化疗后,EpCAMmRNA阳性的患者与EpCAM mRNA阴性的患者相比,中位TTP明显缩短,分别为7.1个月和11.1个月(P=0.013).亚组分析显示,一线和二线化疗的患者,TTP存在明显差别(P =0.018),而三线及三线以上化疗的患者TTP无明显差别(P=0.471).结论:转移性乳腺癌中,EpCAM mRNA的阳性率约为40％.第1周期化疗后,EpCAMmRNA阳性的患者中位TTP明显缩短.