Clinical Significance Of Circulating Tumor Cell Count In Non-metastatic Breast Cancer

Objective: To investigate the relationship between the number of CTCs detected by the Cell Search system in peripheral blood and the clinic pathological features of non-metastatic breast cancer,and to investigate the significance of CTCs count in clinical significance of non-metastatic breast cancer.Methods: Clinical data were collected from 131 patients with stage I to III breast cancer who were diagnosed and treated at Zhongshan Hospital Affiliated to Dalian University from January,2011 to December,2014.131 patients were collected 7.5 ml peripheral blood to detect and analysis CTCs count by Cell Search system.The relationship between CTCs count and patient age,pathological type,tissue grade,vessel infiltration,expression of ER,PR,HER-2,Ki67,tumor stage(tumor size and lymph node metastasis),molecular type of the tumor were compared.Categorical data were processed by SPSS 20.0 statistical software with χ2 test and Fisher’s exact test.The Log Rank test was used for survival analysis.At the same time,long-term follow-up of patients was also performed to assess the relationship between CTCs count and clinical prognosis.Results: Of the 131 patients,positive and negative CTCs were 68 cases(51.91%)and 63 cases(48.09%),respectively.In subtypes of breast cancer molecular classification,The total number of CTCs positive patients of Luminal A type,Luminal B type,Her-2 over expression type and triple negative breast cancer was 3 cases(4.8%),27 cases(42.9%),24 cases(38.1%),9 cases(14.3%),respectively.The total number of CTCs negative patients of Luminal type A,Luminal B type,Her-2 positive type,Triple negative breast cancer was 3 cases(4.4%),49 cases(72.1%),9 cases(13.2%),7 cases(10.3%),respectively.In addition,the number of CTCs in the patients was related to the molecular type of the tumor(P=0.004).The number of CTCs in breast cancer was not correlated with age,pathological type,histological grade,vessel infiltration,the expression of ER,PR,HER-2,Ki-67,tumorstage(tumor size and lymph node metastasis)(P> 0.05).Of 80-followed-up patients,the number of CTCs positive rate was 20/24(83.33%)in Her-2 over expression breast cancer,including 4 patients with recurrence and metastasis,5 patients with death.One of them in negative CTC in Her-2 over expression breast cancer had been dead.Conclusion: The CTCs count in patients with non-metastatic breast cancer was related to the molecular type of the tumor,providing the evidence for future clinical prognosis.