利用循环肿瘤细胞检测进行乳腺癌患者根治手术后复发转移的监控及扶正消瘤汤干预效果

Monitoring of recurrence and metastasis of breast cancer patients after radical operation by circulating tumor cell detection and clinical study of intervention effect of Fuzheng Xiaoliu Decoction

关键词:  乳腺癌  循环肿瘤细胞  复发转移  扶正消瘤汤  干预效果

Key words:  breast cancer  circulating tumor cell  recurrence and metastasis  Fuzheng Xiaoliu Decoction  intervention effect

摘要:

[目的] 研究利用循环肿瘤细胞（CTC）检测进行乳腺癌患者根治手术后复发转移的监控及扶正消瘤汤干预效果。[方法] 选择在深圳市第二人民医院就诊的早中期乳腺癌并已完成根治性手术的患者120例作为观察对象。其中CTC阳性者91例；CTC阴性者29例。将所有受试者按照随机数表法分成观察组和对照组各60例。观察组术后予以扶正消瘤方颗粒剂型中药口服，对照组则给予常规治疗。分析CTC与乳腺癌患者临床病理特征以及复发转移的关系，评价CTC诊断乳腺癌复发转移的灵敏度、特异度，并对扶正消瘤汤对乳腺癌的干预效果进行分析。[结果] CTC阳性者的肿瘤大小≥2 cm、TNM分期为Ⅲ～Ⅳ级、无术后辅助放化疗人数占比以及ER、PR、HER-2阳性率均高于CTC阴性者（P<0.05）。CTC阳性乳腺癌患者根治手术后复发率、转移率均高于CTC阴性者（P<0.05）。CTC检测诊断乳腺癌患者根治手术后复发的灵敏度、特异度分别为89.47%、97.03%；诊断转移的灵敏度、特异度分别为91.67%、98.15%。观察组口服扶正消瘤汤后第1、2、3、4周期时的CTC水平均显著低于对照组（P<0.05）。[结论] 定期检测乳腺癌患者根治手术后CTC水平，有助于复发转移的监控。且扶正消瘤汤可在一定程度上改善CTC水平，继而达到改善预后的目的。

Abstract:

[Objective] To study the monitoring of recurrence and metastasis of breast cancer patients after radical surgery by using circulating tumor cells (CTC) and to analyze the effect of Fuzheng Xiaoliu Decoction intervention.[Methods] The120 patients with early and middle stage breast cancer who had completed radical surgery in Shenzhen second people's hospital were selected as the observation object. In which had 91 CTC positive cases and 29 CTC negative cases. All subjects were divided into observation group and control group with 60 cases in each according to the random number table. After the operation,the observation group was given Fuzheng Xiaoliu Decoction orally,while the control group was given normal treatment. The relationship between CTC and the clinicopathological features and recurrence and metastasis of breast cancer patients,to evaluate the sensitivity and specificity of CTC in the diagnosis of recurrence and metastasis of breast cancer were analyzed,the effect of Fuzheng Xiaoliu Decoction interventionwereevaluated.[Results] The proportion of tumor which size was 2 cm or more,the proportion of tumor which TNM staging was Ⅲ~Ⅳ,the proportion of no adjuvant radiation and chemotherapy after surgery and the positive rate of ER,PR,HER-2 in CTC positive patients were higher than those in the CTC negative patients(P<0.05). The recurrence rate and metastasis rate of breast cancer in the CTC positive patients were higher than those in the CTC negative patients(P<0.05). Compared with the imaging examination,the sensitivity and specificity of CTC in diagnosing the recurrence of breast cancer after radical surgery were 89.47% and 97.03%,respectively. The sensitivity and specificity of CTC in diagnosing the metastasis were 91.67% and 98.15%,respectively. Under the intervention of Fuzheng Xiaoliu Decoction,the CTC level in the observation group was significantly lower than that in the control group (P<0.05).[Conclusion] It is helpful to monitor the recurrence and metastasis of breast cancer by regularly detecting CTC level after radical operation. Moreover,Fuzheng Xiaoliu Decoction can improve the CTC level to a certain extent,and then achieve the goal of improving the prognosis.