CAJ | 학술논문

目的：探讨化学发光法检测可手术乳腺癌患者血清HER-2／neu ECD浓度与组织HER-2表达水平的相关性。方法采用西门子化学发光仪检测2012年12月至2013年12月收治的84例可手术乳腺癌患者血清HER-2／neu ECD水平，并采用同期的58例乳腺良性病变患者及56例健康体检女性作为对照；同时对84例可手术乳腺癌患者进行组织HER-2表达的检测。结果可手术乳腺癌患者血清HER-2／neu ECD水平及阳性率分别为（15．56±6．79） ng／ml、19．05％，明显高于乳腺良性病变患者的（6．21±3．21）ng／ml、0．00％，及健康体检者的（5．13±2．25）ng／ml、0．00％，P均＜0．05。34例组织HER-2表达阳性的可手术乳腺癌中有14例血清HER-2／neu阳性，阳性符合率为41．2％；50例组织HER-2表达阴性的可手术乳腺癌中有48例血清HER-2／neu阴性，阴性符合率为96．0％；血清HER-2／neu水平与组织HER-2表达状态具有较好的一致性，（kappa＝0．406，P＜0．05）。结论化学发光法检测可手术乳腺癌患者血清HER-2／neu浓度与组织HER-2表达水平具有较好的一致性。因此，乳腺癌患者在系统治疗期间，可通过化学发光法动态监测患者血清HER-2／neu ECD水平，可弥补组织HER-2检测的不足，在乳腺癌随访、疗效监测尤其是用Herceptin治疗后的疗效监测中发挥其独到作用。
목적：탐토화학발광법검측가수술유선암환자혈청HER-2／neu ECD농도여조직HER-2표체수평적상관성。방법채용서문자화학발광의검측2012년12월지2013년12월수치적84례가수술유선암환자혈청HER-2／neu ECD수평，병채용동기적58례유선량성병변환자급56례건강체검녀성작위대조；동시대84례가수술유선암환자진행조직HER-2표체적검측。결과가수술유선암환자혈청HER-2／neu ECD수평급양성솔분별위（15．56±6．79） ng／ml、19．05％，명현고우유선량성병변환자적（6．21±3．21）ng／ml、0．00％，급건강체검자적（5．13±2．25）ng／ml、0．00％，P균＜0．05。34례조직HER-2표체양성적가수술유선암중유14례혈청HER-2／neu양성，양성부합솔위41．2％；50례조직HER-2표체음성적가수술유선암중유48례혈청HER-2／neu음성，음성부합솔위96．0％；혈청HER-2／neu수평여조직HER-2표체상태구유교호적일치성，（kappa＝0．406，P＜0．05）。결론화학발광법검측가수술유선암환자혈청HER-2／neu농도여조직HER-2표체수평구유교호적일치성。인차，유선암환자재계통치료기간，가통과화학발광법동태감측환자혈청HER-2／neu ECD수평，가미보조직HER-2검측적불족，재유선암수방、료효감측우기시용Herceptin치료후적료효감측중발휘기독도작용。
Objective To explore the correlation between concentration of HER-2/neu ECD and HER-2 expression level in tissues by chemiluminescence.Methods Siemens chemiluminescence apparatus was used to detect the serum HER-2/neu ECD level in 84 operable breast cancer patients.58 patients with breast benign lesions over the same period and 56 cases of healthy patients were selected as contrast.HER-2 expression level in tissues of 84 cases of breast cancer patients were detected. Results HER-2/neu ECD levels and serum positive rate of the breast cancer patients were 15.56 ±6.79 ng/ml and 19.05%, which were significantly higher than patients with breast benign lesions (6.21 ±3.21 ng/ml,0.00%) and healthy patients (5.13 ±2.25 ng/ml,0.00%),P<0.05.There were 14 cases of positive serum HER-2/neu in 34 operable breast cancer patients with positive expression of HER-2,positive coincidence rate was 41.2%.There were 48 cases of negative serum HER-2/neu in 50 op-erable breast cancer patients with negative expression of HER-2,negative coincidence rate was 96%.The serum HER-2/neu level had good consistency with expression of HER-2(kappa=0.406,P<0.05).Conclusion Serum Her-2/neu concentration in op-erable breast cancer patients has good consistency with expression of HER-2 by chemiluminescence.During the system treatment for breast cancer patients,dynamic monitoring of serum HER-2/neu ECD level by chemiluminescence can make up for the insuffi-ciency of HER-2 detection.It plays an unique role in the follow-up of breast cancer patients and monitoring of efficacy,especially monitoring of efficacy after treatment with Herceptin.