Xu Wanwen, Yuan Feng
Department of Dermatology, Wuhan Third Hospital, Wuhan, Hubei, China.
Department of Breast Surgery, Hubei Provincial Clinical Research Center for Breast Cancer, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
J Clin Lab Anal. 2025 Jan;39(1):e25126. doi: 10.1002/jcla.25126. Epub 2024 Dec 18.
Breast cancer (BC) is an aggressive tumor. Circulating tumor cells (CTCs) are a potential biomarker for the prognosis of cancer patients. This study aimed to explore the prognostic significance of CTCs in patients with BC.
Retrospectively, 108 BC patients were collected between January 2011 and December 2019, while 10 patients with benign nodules were included as controls. CTCs with different phenotypes of patients were isolated using CanPatrol and tricolor RNA in situ hybridization (RNA-ISH) methods. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) levels were measured by immunohistochemistry (IHC). The progression-free survival (PFS) was calculated using the Kaplan-Meier method. Independent risk factors for BC recurrence were determined by Cox proportional risk regression analysis.
The higher the cancer stage (p = 0.00), the higher the ki-67 expression level (p < 0.01), and the lower the histologic grade (p < 0.01), the higher the number of CTCs. The PFS of patients with high CTCs was shorter than that of patients with low CTCs (p < 0.05). Total CTCs (≥ 6) and positive mesenchymal CTCs (MCTCs) were also associated with recurrence and metastasis.
Total CTCs in BC patients have an independent influence on PFS reduction. Higher total CTCs and MCTCs in peripheral blood are biomarkers for predicting the prognosis of BC patients. HER-2 high expression is also associated with the prognosis of the disease.
乳腺癌（BC）是一种侵袭性肿瘤。循环肿瘤细胞（CTC）是癌症患者预后的潜在生物标志物。本研究旨在探讨CTC在BC患者中的预后意义。
回顾性收集2011年1月至2019年12月期间的108例BC患者，同时纳入10例良性结节患者作为对照。采用CanPatrol和三色RNA原位杂交（RNA-ISH）方法分离患者不同表型的CTC。通过免疫组织化学（IHC）检测雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER-2）水平。采用Kaplan-Meier法计算无进展生存期（PFS）。通过Cox比例风险回归分析确定BC复发的独立危险因素。
癌症分期越高（p = 0.00）、ki-67表达水平越高（p < 0.01）、组织学分级越低（p < 0.01），CTC数量越高。高CTC患者的PFS短于低CTC患者（p < 0.05）。总CTC（≥6）和阳性间充质CTC（MCTC）也与复发和转移相关。
BC患者的总CTC对PFS降低有独立影响。外周血中较高的总CTC和MCTC是预测BC患者预后的生物标志物。HER-2高表达也与疾病预后相关。
