CAJ | 학술논문

目的探讨血清HER-2/neu胞外域(ECD)在复发转移性乳腺癌患者解救化疗中的临床意义.方法酶联免疫吸附试验检测健康志愿者、良性乳腺疾病患者各27例的血清HER-2/neu ECD水平及27例复发转移性乳腺癌患者化疗前后的血清HER-2/neu ECD水平,结合其临床资料进行统计学分析.结果健康志愿者与乳腺良性疾病患者血清HER-2/neu ECD水平均低于15μg/L,差异无统计学意义(P>0.05);复发转移性乳腺癌患者化疗前血清HER-2/neu ECD的平均浓度为(47.30±109.06)μg/L,显著高于健康志愿者及乳腺良性疾病患者(P<0.01).血清HER-2/neu ECD水平与原发肿瘤HER-2/neu的表达成正相关(r=0.752,P<0.01).解救化疗有效的患者,化疗3周后血清HER-2/neu ECD水平较化疗前明显降低(P<0.05),化疗3周后与化疗6周后血清HER-2/neu ECD水平差异无统计学意义(P>0.05).化疗前HER-2/neu ECD水平与患者总生存期呈负相关(r=-0.601,P<0.01),而与无进展生存期无明显相关(r=-0.374,P>0.05).化疗前血清HER-2/neu ECD>15 ug/L与HER-2/neu ECD<15 ug/L的患者比较,总生存率前者低于后者(P<0.05),无进展生存率两者间差异无统计学意义(P>0.05).结论血清HER-2/neu ECD水平的监测,有助于早期发现乳腺癌的复发转移,指导解救化疗方案的选择,评估患者的疗效及预后.
목적 탐토혈청HER-2/neu포외역(ECD)재복발전이성유선암환자해구화료중적림상의의.방법 매련면역흡부시험검측건강지원자、량성유선질병환자각27례적혈청HER-2/neu ECD수평급27례복발전이성유선암환자화료전후적혈청HER-2/neu ECD수평,결합기림상자료진행통계학분석.결과 건강지원자여유선량성질병환자혈청HER-2/neu ECD수평균저우15μg/L,차이무통계학의의(P>0.05);복발전이성유선암환자화료전혈청HER-2/neu ECD적평균농도위(47.30±109.06)μg/L,현저고우건강지원자급유선량성질병환자(P<0.01).혈청HER-2/neu ECD수평여원발종류HER-2/neu적표체성정상관(r=0.752,P<0.01).해구화료유효적환자,화료3주후혈청HER-2/neu ECD수평교화료전명현강저(P<0.05),화료3주후여화료6주후혈청HER-2/neu ECD수평차이무통계학의의(P>0.05).화료전HER-2/neu ECD수평여환자총생존기정부상관(r=-0.601,P<0.01),이여무진전생존기무명현상관(r=-0.374,P>0.05).화료전혈청HER-2/neu ECD>15 ug/L여HER-2/neu ECD<15 ug/L적환자비교,총생존솔전자저우후자(P<0.05),무진전생존솔량자간차이무통계학의의(P>0.05).결론 혈청HER-2/neu ECD수평적감측,유조우조기발현유선암적복발전이,지도해구화료방안적선택,평고환자적료효급예후.
Objective To investigate the clinical significance of the extracellular domain (ECD) of the HER-2/neu receptor in serum in patients with recurrent and metastatic breast cancer receiving salvage chemotherapy, nethods HER-2/neu ECD in sera obtained from 27 healthy volunteers,27 patients with be-nign breast disease, and 27 patients with recurrent and metastatic breast cancer around chemotherapy was measured by ELISA,and statistically analyzed in combination with clinical data. Results There was no sig-nificant difference in HER-2/neu ECD levels (below 15 μg/L) between healthy volunteers and patients with benign breast disease (P>0.05). The mean concentration of HER-2/neu ECD in patients with recurrent and metastatic breast cancer before salvage chemotherapy was (47.30±109.06) μg/L. As compared with healthy volunteers and patients with benign breast disease, patients with recurrent and metastatic breast canc-er had significantly higher levels of HER-2/neu ECD (P<0.01). There was a significant correlation be-tween HER-2/neu expression in primary tumor detected by immunohistechemistry and HER-2/neu ECD de-tected by ELISA (r=0.752,P<0.01 ). A decrease in HER-2/neu ECD levels from baseline was found at week 3 in patients response for salvage chemotherapy (P<0.05),which was similar to that at week 6 (P> 0.05). The HER-2/neu ECD levels before chemotherapy had a negative correlation with overall survival (r=-0.601, P<0.01), but had no correlation with progression free survival (r=-0.374,P>0.05). As compared with patients with baseline below 15 μg/L,patients with initially elevated HER-2/neu ECD levels (>15 μg/L) had lower overall survival rate (P<0.05) and similar progression free survival (P>0.05). Conclusion The monitoring of HER-2/neu ECD levels is helpful to detect recurrence and metastasis of breast cancer,select regimen of salvage chemotherapy as well as evaluate the efficacy and prognosis.