A Preliminary Study Of The Correlation Between The Circulating Tumor Cells And The Prognosis Of The Metastatic Breast Cancer

Objective:The aim of this study was to to apply Moflo XDP FCM to detect the Circulating Tumor Cells in peripheral blood in patients with metastatic breast cancer (Circulating Tumor Cells, CTCs) expression, Observe whether CTCs chemotherapy curative effect can be predicted in advance, and study the relationship.of CTCs and clinical prognostic factors and the Progression-free survival further.Methods:Included in the study were 60 patients who were diagnosed by pathology using disposable biopsy needle between February 2013 and February 2014 with primary invasive breast cancer stages IV. All of the patients should receive Palliative chemotherapy at least 2 cycles, we collect the blood samples on the day before the first cycle of chemotherapy and the day before the second cycle of chemotherapy. We evaluated response of Palliative chemotherapy after the second cycle according to RECIST (response evaluation criteria in solid tumors) 1.1 (2009 edition) [1] (Response Evaluation Criteria in solid tumors, RECIST). All patients follow-up deadline is on September 30,2014, from the experiment that began to collect the data until disease progression or death as the end point of observation. Using SPSS 17.0 statistical software package for data statistical analysis.Results:l.The sensitivity of Using Moflo XDP FCM to detecte the peripheral blood in patients with metastatic breast cancer CTCs can reach 1* 10-6;2.A11 of the 20 female healthy volunteers CTCs detection are negative; Among 60 patients with metastatic breast cancer, detection of the CTCs positive rate before chemotherapy is 61.67%, and that after one cycle is 21.67%, the difference was statistically significant (P= 0.000).3. To compare the variation of Before and after chemotherapy in patients with peripheral blood CTCs, the difference was statistically significant (P= 0.007), but there was no significant difference with the patient age, tumor location, tumor size, ER, PR, HER-2 and the expression of Ki-67 (P> 0.05);4. After two cycles of chemotherapy,60 cases of patients with chemotherapy, the total effective rate was 45%, the detection of CTCs state before and after chemotherapy for patients with positive-negative, negative-negative state of the clinical effective rate were 63%,42%, which is higher than the positive-positive (10%), negative-positive (25%) patients (P= 0.008).5. The objective response rate (ORR) of patients with CTCs-negative undertaken one cycle chemotherapy was 53.2%, which is significantly higher than that the CTCs positive patients (15.4%) (P= 0.015); CTCs descend group got a better ORR than that CTCs increased group after chemotherapy (P= 0.022). The CTCs negative patients before Chemotherapy ORR is (39.1%),with CTCs express positive ORR is (48.6%), there was no statistically significant difference (P= 0.471).6.60 patients had be enrolled in this study.The Overall median PFS was 51 weeks, PFS among -negative patients after one cycle chemotherapy was increased,than CTCs express positive (P= 0.000); PFS among CTCs decrease patients was increased,than CTCs rise after one cycle chemotherapy (P= 0.000), which gave rise to a little higher ORR (P= 0.022);Conclusion:1,The application of Moflo XDP FCM detecting metastatic breast cancer peripheral blood circulating tumor cells has high sensitivity and specificity;2, The expression of CTCs level before and after chemotherapy CTCs in peripheral blood is different in different types of breast cancer molecular, the Reduction rate of CTCs in LuminalA type patients with breast cancer lower than HER-2 positive,LuminalB type and three negative; While Menstruation status, tumor size, metastasis, tumor type, ER, PR, its HER-2 and Ki-67 these prognostic factor expression have no obvious correlation;3, There has a significantly droop rate of CTCs after palliative chemotherapy; The CTCs rising or fall was associated with the efficacy of chemotherapy,which prompts CTCs changes before and after chemotherapy can predict chemotherapy curative effect timely;4, PFS among CTCs descend patients after one cycle chemotherapy was significantly increased,than that CTCs rise group,which prompts CTCs changes may be able to predict the prognosis of breast cancer.