摘要
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）LuminalA型、42．7％（44／103）LuminalB—HER2（-）型、70．6％（60／85）LuminalB—HER2（＋）型、73．8％（45／61）HER2过表达型、23．1％（9／39）三阴型患者ECD≥15μg/L，各分子亚型间的差异有统计学意义（P〈0．001）。患者的血清HER2ECD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。
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 effieacies of targeted treatment.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第18期1384-1387,共4页
National Medical Journal of China
基金
首都医学发展科研基金（2009-2044）
新药重大创新专项课题资助项目（2013ZX09J13202）
