胃癌患者45例外周血肿瘤干细胞样循环肿瘤细胞的检测  

Detection of cancer stem cell like circulating tumor cells in peripheral blood of 45 patients with gastric cancer

作　　者：李熳[1] 张志广[1] 刘霞[1] 罗丹[1] 

机构地区：[1]天津医科大学第二医院消化内科,300211

出　　处：《中华消化杂志》2015年第11期726-729,共4页Chinese Journal of Digestion

基　　金：天津市高等学校科技发展基金计划项目（20110130）

摘　　要：目的研究胃癌患者外周血中CD44（胃癌干细胞标志物）阳性的循环肿瘤细胞（CTC）的表达及其意义。方法纳入2010年3月至2012年12月的45例胃癌患者和20名健康体检者。采集所有纳入对象的外周血，应用密度梯度离心法和双重免疫荧光法（细胞角蛋白19／CD44）检测CTC和CD44阳性的CTC。统计学分析采用卡方检验和t检验。结果健康对照者外周血中未检出CTC。45例胃癌患者外周血中，27例（60％）检出CTC，其中19例为CD44阳性。两组CTC阳性率差异有统计学意义（X2=10．986，P〈0．05）。27例CTC阳性的患者中，近端胃癌19例，其中16例为CD44阳性；16例出现淋巴结转移，其中14例为CD44阳性；13例出现远处转移，其中12例为CD44阳性；14例出现复发，其中13例为CD44阳性；CD44阳性的CTC与胃癌患者的肿瘤部位、淋巴结转移、远处转移和复发有关（X2=5．89l、5．527、5．787、7．052，P均〈0．05）。13例复发的CD44阳性CTC患者，其复发时间为（10．54±5．55）个月，短于1例CD44阴性CTC患者的19个月，差异有统计学意义（t=-3．654，P=0．004）。结论表达肿瘤干细胞标志物的CTC与胃癌的复发转移相关，检测这部分亚群的CTC可能更有临床意义。Objective To explore the expression and significance of CD44 gastric cancer stem cell biomarker positive circulating tumor ceils （CTC） in peripheral blood of patients with gastric cancer. Methods From March 2010 to December 2012, 45 patients with gastric cancer and 20 healthy individuals were enrolled. Peripheral blood samples of all the subjects were collected. The expression of CTC and CD44 postive CTC were detected by density gradient centrifugation method and double immunofluorescent staining. Chi-square test and t test were performed for statistical analysis. Results CTC in peripheral blood of healthy controls were not detected. Among 45 patients with gastric cancer, CTC were detected in 27 patients and 19 of them were CD44-positive. The difference in positive rate of CTC expression was statistically significant between two groups （X2=10. 986, P〈0.05）. Among 27 CTC positive patients, 19 were proximal gastric cancer and 16 of them were CD44 positive;16 patients had lymph node metastasis and 14 of them were CD44-positive;13 patients had distant metastasis and 12 of them were CD44 positive; 14 patients had recurrence and 13 of them were CD44 positive. The CD44 positive CTC was correlated with tumor location, lymph node metastasis, distant metastasis and recurrence （ X2=5.891, 5. 527,5. 787 and 7. 052,respectively, all P^0.05）. Furthermore, in 13 patients with recurrence and CD44 positive CTC, the recurrence time was （10.54±5. 55） months which was shorter than that of one patients with CD44 negative CTC （19 months）, and the difference was statistically significant （t= 3. 654, P = 0. 004）. Conclusions CTC which express cancer stem cell marker may be associated with recurrence and metastasis of gastric cancer. It has more important clinical significance to detect this subtype of CTC.

关 键 词：胃肿瘤 肿瘤循环细胞 肿瘤干细胞 循环肿瘤干细胞 CD44 

分 类 号：R735.2[医药卫生—肿瘤]