结直肠癌患者外周循环肿瘤细胞的变化及临床意义  

Colorectal cancer patients with peripheral circulating tumor cells of the change and clinical signifi- cance

作　　者：庞明辉[1] 罗坤[2] 侯能易[1] 苟莉[1] 付俊文[1] 罗斌[1] 周晓刚[1] 漆家康 王康[1] 

机构地区：[1]四川省医学科学院四川省人民医院胃肠外科,成都610072 [2]宜宾市第二人民医院胃肠外科,宜宾644000

出　　处：《中华实验外科杂志》2017年第1期35-37,共3页Chinese Journal of Experimental Surgery

基　　金：2013年四川省卫生厅项目（130163）;2011年四川省卫生厅项目（110167）

摘　　要：目的探讨结直肠癌患者循环肿瘤细胞（CTCs）的动态变化对判断其预后的应用价值。方法选择88例临床上首次确诊为结直肠癌患者，应用第2代CTCs富集方法及荧光显影技术，分别于手术前1 d、手术后1个月末、6个月末及12个月末检测的外周血CTCs。分析患者在不同时期的CTCs、组织分型及淋巴结转移情况。依据12个月末测量的CTCs值同1个月末测量的CTCs比较是否增高，分为增高组和非增高组，比较两组生存时间及复发情况。结果88例结直肠癌患者中，回盲部及升结肠癌18例，降结肠癌10例，乙状结肠癌20例，直肠癌40例。其中，男47例，年龄51～86岁，女41例，年龄42～88岁。在分组比较中，增高组56例，非增高组32例。两组基线水平比较差异均无统计学意义（χ2＝0.002，t＝0.780，P＝0.950）；组织学分化程度低者，CTCs水平高于分化程度高者，差异有统计学意义（F＝12.28，P＝0.001）；淋巴结转移的患者CTCs水平高于无转移者，差异有统计学意义（F＝57.37，P＝0.001）；增高组患者生存时间小于非增高组（χ2＝10.665，P＝0.001），复发例数高于非增高组（χ2＝5.684，P＝0.017），差异均有统计学意义。结论监测CTCs值动态变化对结直肠癌患者肿瘤复发的早期判断、手术的评判、术后化疗的疗效，以及术后短期内复发的Ⅱ、Ⅲ期结直肠癌患者和Ⅳ期患者的治疗方案选择及改进有指导意义。Objective Explore the dynamic changes of the patients with colorectal cancer circulating tumor cells （CTCs） in judging the prognosis, adjust the application value of treatment.Methods Select 88 cases of clinically diagnosed with colorectal cancer patients for the first time, the method of the second generation of enrichment of circulating tumor cells and fluorescence imaging technique, 1 day before the surgery, 1 month after the surgery, in late June and late December four detection of CTCs in peripheral blood. Analysis of patients in different periods of whether CTCs value, histological type, lymph node metastasis. Measurement based on the end of December of CTCs values compared with January measurement of CTCs is increased, divided into higher and higher than groups, compared two groups of recurrence and survival time.Results Of 88 patients with colorectal cancer, back to the blind and litres of 18 cases of colorectal cancer, 10 cases of colorectal cancer, 20 patients with sigmoid colorectal cancer, rectalcancer 40 cases, among them, the males 47 cases, aged 51-86 years old, 41 cases were female, aged 42-88 years old. Higher in group comparison, groups： 56 cases, higher than group of 32 cases. The baseline is similar between the two groups had no statistical significance （χ2=0.002, t=0.780, P=0.950）; Residency histological differentiation degree, CTCs is higher than the degree of differentiation, the difference was statistically significant （F=12.28, P=0.001）; In patients with lymph node metastasis of CTCs is higher than without metastasis, the difference was statistically significant （F=57.37, P=0.001）; Increased survival time less than the higher group, （χ2=10.665, P=0.001）, increased cases of recurrence is higher than the group （χ2=5.684, P=0.017）, the difference had statistical significance.Conclusion Monitoring CTCs value dynamic changes of tumor recurrence in patients with colorectal cancer early judgment of judgment, the curative effect of postoperative chemotherapy, surgery,

关 键 词：循环肿瘤细胞 结直肠癌 预后 

分 类 号：R735.34[医药卫生—肿瘤]