CAJ | 학술논문

目的探讨不同分子亚型晚期乳腺癌患者血清人表皮生长因子受体2(HER2)配体结合域(ECD)的表达及意义.方法采用酶联免疫吸附法(ELISA)定量检测322例晚期乳腺癌患者的血清HER2ECD水平,分析其与临床病理特征的关系及意义.结果 55.9％ (19/34) Luminal A型、42.7％ (44/103) Luminal B-HER2(-)型、70.6％(60/85) Luminal B-HER2(+)型、73.8％ (45/61)HER2过表达型、23.1％ (9/39)三阴型患者ECD≥15 μg/L,各分子亚型间的差异有统计学意义(P＜0.001).患者的血清HER2 ECD的阳性检出率与组织学HER2状态、转移器官数、内脏转移情况、CA15-3及CEA水平具有相关性.组织学HER2阳性靶向治疗有效的患者治疗后ECD检测中位值较疗前下降(P＜0.05).结论不同分子亚型晚期乳腺癌患者的血清HER2ECD阳性检出率不同,血清HER2ECD水平除能在一定程度上反映组织学HER2状态外,同时能较好地反映不同分子亚型乳腺癌患者的肿瘤负荷,并且检测值的动态变化与靶向治疗疗效具有一定的相关性.
목적 탐토불동분자아형만기유선암환자혈청인표피생장인자수체2(HER2)배체결합역(ECD)적표체급의의.방법 채용매련면역흡부법(ELISA)정량검측322례만기유선암환자적혈청HER2ECD수평,분석기여림상병리특정적관계급의의.결과 55.9％ (19/34) Luminal A형、42.7％ (44/103) Luminal B-HER2(-)형、70.6％(60/85) Luminal B-HER2(+)형、73.8％ (45/61)HER2과표체형、23.1％ (9/39)삼음형환자ECD≥15 μg/L,각분자아형간적차이유통계학의의(P＜0.001).환자적혈청HER2 ECD적양성검출솔여조직학HER2상태、전이기관수、내장전이정황、CA15-3급CEA수평구유상관성.조직학HER2양성파향치료유효적환자치료후ECD검측중위치교료전하강(P＜0.05).결론 불동분자아형만기유선암환자적혈청HER2ECD양성검출솔불동,혈청HER2ECD수평제능재일정정도상반영조직학HER2상태외,동시능교호지반영불동분자아형유선암환자적종류부하,병차검측치적동태변화여파향치료료효구유일정적상관성.
Objective To evaluate the serum HER2 ECD level and its significance in advanced breast cancer patients with different molecular subtypes.Methods A total of 322 advanced breast cancer patients were enrolled.The serum HER2 ECD concentrations were quantitatively detected by enzyme-linked immunosorbent assay (ELISA).Its relationship with clinicopathological characteristics and clinical significance were analyzed.Results It was found that 55.9％ (19/34) Luminal A,42.7％ (44/103) Luminal B-HER2 (-),70.6％ (60/85) Luminal B-HER2 (+),73.8％ (45/61) HER2-enriched and 23.1％ (9/39)triple-negative patients had serum concentrations of HER2 ECD at least 15 ng/ml respectively.The prevalence of elevated ECD level in patients of different molecular subtypes differed significantly(P ＜ 0.001).Tissue HER2 status,number of metastatic sites,visceral metastasis,CA15-3 and carcinoembryonic antigen(CEA) levels exhibited statistically significant correlations with the prevalence of elevated serum HER2 ECD level.The serum concentrations of HER2 ECD decreased after effective targeted therapy in tissue HER2-positive patients.Conclusion The prevalence of elevated serum levels of HER2 ECD differed significantly in advanced breast cancer patients with different molecular subtypes.The serum HER2 ECD level may reflect both histological HER2 status and tumor load.And the dynamic changes of ECD concentrations are somewhat correlated with the efficacies of targeted treatment.