进展期结直肠癌患者循环肿瘤细胞水平及其与患者临床特征和预后的关系  

Relationship between circulating tumor cells level and clinicopathological features and prognosis in patients with advanced colorectal cancer

作　　者：黄天臣[1] 冯留顺[2] 肖建安[1] 白东晓[1] 王青兵[1] 王雁军[1] 张勇[1] 李衎 王文龙 Huang Tianchen;Feng Liushun;Xiao Jian'an;Bai Dongxiao;Wang Qingbing;Wang Yanjun;Zhang Yong;Li Kan;Wang Wenlong(The Fourth Department of General Surgery,Anyang Tumor Hospital,Anyang 455000,China;Department of General Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]河南省安阳市肿瘤医院外四科,455000 [2]郑州大学第一附属医院普外科,450052

出　　处：《中华实验外科杂志》2018年第12期2314-2317,共4页Chinese Journal of Experimental Surgery

摘　　要：目的探讨进展期结直肠癌患者循环肿瘤细胞(CTC)水平与患者临床病理特征和预后的关系。方法我院接受治疗的180例进展期结直肠癌患者和50例同期非肿瘤患者外周静脉血,采用流式细胞术检测CK+4’,6-二脒基-2-苯基吲哚(DAPI)+CD45-的CTC细胞,并根据CTC进行分组,分析CTC与患者临床病理特征以及预后的关系。结果成功检测结直肠癌患者CTC,180例进展期结直肠癌患者CTC阳性74例(41.11%),阴性者106例(58.89%)。CTC与肿瘤分化程度、临床分期、是否远端转移、血清癌胚抗原(CEA)水平以及淋巴结转移等指标均有相关(P=0.017、0.023、0.000、0.000、0.000)。CTC阳性组患者的中位无进展生存期(26个月)和总生存期(57个月)明显低于阴性组患者的中位无进展生存期(37个月)和总生存期(92个月),差异有统计学意义(Log-rank=3.193,P=0.014;Log-rank=5.109,P=0.007)。Cox比例风险回归模型,发现肿瘤分化程度、临床分期、是否远端转移、淋巴结转移和CTC等指标与总生存率和无进展生存期均存在相关性(P=0.015、0.032、0.018、0.027、0.009;P=0.009、0.020、0.011、0.031、0.006)。CTC是影响患者术后总生存期和无进展生存期的独立风险因素(P=0.009、0.006)。结论CTC与进展期结直肠癌患者临床病理特征和预后密切相关。Objective To investigate the relationship between circulating tumor cells (CTC) and clinicopathological characteristics and prognosis in patients with advanced colorectal cancer. Methods 180 cases of advanced colorectal cancer and 50 non tumor peripheral venous blood were collected from March 2016 to August 2017 in our hospital. The CTC cells of CK+ 4’, 6-diamidino-2-phenylindole (DAPI)+ CD45- were detected by flow cytometry. the relationship between CTC and the clinicopathological features and prognosis was analyzed by CTC. Results The circulating tumor cells were detected successfully in this study. 74 cases (41.11%) were positive for circulating tumor cells in 180 patients with advanced colorectal cancer, and 106 cases (58.89%) were negative. Circulating tumor cells was correlated with tumor differentiation, clinical stage, distal metastasis, serum carcinoembryonic antigen (CEA) level and lymph node metastasis (P=0.017, 0.023, 0.000, 0.000, 0.000). The median progression free survival (26 months) and total survival (57 months) in the circulating tumor cell positive group were significantly lower than those of the negative group (37 months) and the total survival period (92 months). The difference was statistically significant (Log-rank=3.193, P=0.014; Log-rank=5.109, P=0.007). The Cox proportional risk regression model found that tumor differentiation, clinical stage, distal metastasis, lymph node metastasis, and tumor circulating cells were correlated with total survival and progression free survival (P=0.015, 0.032, 0.018, 0.027, 0.009; P=0.009, 0.020, 0.011, 0.031, 0.006). Circulating tumor cells are independent risk factors affecting overall postoperative survival and progression free survival (P=0.009, 0.006). Conclusion Circulating tumor cells are closely related to the clinicopathological features and prognosis of patients with advanced colorectal cancer.

关 键 词：进展期结直肠癌 循环肿瘤细胞 临床病理特征 预后 

分 类 号：R735.34[医药卫生—肿瘤]