Abstract

Objective. To evaluate the clinical significance of the expression of birc5 and her2-neu genes in circulating tumor cells as markers of minimal residual disease at the stage of surgical treatment of breast cancer. Methods. 162 patients with the verified breast cancer of the I–IIIC stage aged 58.16±9.98 years took part in the study. All women underwent surgery in the amount of a Madden radical mastectomy – 113 (69.8%) or radical resection – 49 (30.2%). All patients on the day of surgery and also on the 2nd day after the operation were examined for the presence of circulating tumor cells (CTCS) in the peripheral blood. For the identification of CTCS, expression of the birc5 and her2-neu genes was studied using real-time polymerase chain reaction (rt-Pcr). Results. Positive MRNAS BIRC5 and HER2-neu CTCS before the surgery were detected in 115 women (71%). After the operation, CTCS disappeared in 47 (40.9%) patients, in 59 (51.3%) CTCS were preserved, and in 9 (7.8%) CTCS were first identified in the venous blood. After mastectomy the frequency of preservation of CTCS was significantly lower than after radical resection and was 46.9% compared to 61.8% (p=0.039). The frequency of preservation of CTCS after surgery was significantly higher in the early stages (I–IIA) – 66.2% than in more advanced stages (IIB–IIIC) – 45.0%. Conclusions. Determination of the expression of the BIRC5 and HER2-neu gene in the enriched peripheral blood sample is a reliable identifier of the CTCS and the minimal residual disease marker. Early dissemination of tumor cells helps maintain CTCS in the peripheral blood of patients to 51.3%, despite the surgical intervention.

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