肝癌患者术中循环血肿瘤细胞的变化  

Changes of circulating tumor cells of liver cancer patients during surgery

作　　者：李玲[1,2,3] 杜磊[2] 朱昭琼[1] 

机构地区：[1]遵义医学院附属医院麻醉科,贵州遵义563003 [2]四川大学华西医院麻醉科,四川成都610038 [3]第三军医大学西南医院麻醉科,重庆400038

出　　处：《局解手术学杂志》2014年第6期578-582,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：卫生部卫生行业科研专项项目资助(201002005)

摘　　要：目的研究肝癌切除手术是否会对肝癌患者循环血肿瘤细胞造成影响从而可能增加肝癌患者术后的转移率。方法抽取18例肝癌患者术中切肝前与切肝后循环血及20名健康志愿者的循环血。所有血液样本均进行血常规检测计数白细胞和显微镜下全血有核细胞总数计数,并进行比较。采用免疫荧光法和细胞培养法检测比较各组血液样本中的肿瘤细胞数量与特性。免疫荧光法使用AE1/AE3、CD133标记肿瘤细胞。结果肝癌患者术中切肝后白细胞数和全血有核细胞总数均较切肝前增高。存在AE1/AE3阳性细胞的样本总例数较存在CD133阳性细胞和双阳性细胞的样本总例数多(P<0.001)。健康志愿者循环血中的AE1/AE3阳性细胞数量多于肝癌切肝后循环血(P<0.05),CD133阳性及双阳性的细胞数量在各组间比较无统计学差异(P>0.05)。细胞培养克隆生成率在各组间比较差异无统计学意义(P>0.05),肝癌患者中形成克隆株的3例样本在肿瘤发生来源、肿瘤病理类型及分化程度上无明显区别。结论肝癌患者术中切肝前后循环血、健康人群循环血中均存在肿瘤细胞;肝癌切除手术操作不会影响肝癌患者血液中的循环血肿瘤细胞数量与特性。Objective To study the effect of hepatectomy operation on circulating tumor cells of liver cancer patients during surgery. Methods Circulating blood was draw from 18 liver cancer patients before and after hepatectomy and 20 healthy volunteers. Blood routine ex-amination for leukocyte enumeration and karyote counting by microscope were taken for every blood samples to compare with the number of leukocytes and karyotes between pre-hepatectomy and post-hepatectomy blood of liver cancer patients. Immunofluorescence and cell culture techniques were used to identify the tumor cells and compare with the numbers and characteristics of the circulating tumor cells in blood sam-ples among all groups. Fluorescent antibodies,AE1/AE3 and CD133 were used to mark tumor cells. Results The number of leukocytes and karyotes in post-hepatectomy blood samples of liver cancer patients increased compared with pre-hepatectomy blood samples. The AE1/AE3 positive cells-samples were more than CD133 positive cells-samples and double positive cells-samples（P0. 05）. There were no significant differences in clone formation rate after cell culture among all groups（P〉0. 05）. For 3 clone formed samples of liver cancer patients,there were no differences in tumor source, pathologic type and differentiation level. Conclusion The circulating blood of liver cancer patients,non-cancer patients and healthy people all exist circulating tumor cells. Hepatoma resection does not affect the number and characteristics of circulating tumor cells in liver cancer pa-tients’ blood.

关 键 词：肝癌 肝癌切除手术 循环血肿瘤细胞 转移 复发 

分 类 号：R735.7[医药卫生—肿瘤]