CTCs在膀胱癌转移及预后评估中应用的研究  

Clinical application of CTCs in the evaluation of bladder cancer metastasis and prognosis

作　　者：唐芮鹏 刘建和[1] 李炯明[1] 杨博伟[1] 石鑫[1] 李宇航[1] 方克伟[1] 张劲松[1] 王光[1] 

机构地区：[1]昆明医科大学第二附属医院泌尿外科,617000

出　　处：《现代泌尿生殖肿瘤杂志》2017年第2期76-79,共4页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的检测膀胱癌患者外周血循环肿瘤细胞(circulating tumor cells,CTCs)的计数及分型,研究其在膀胱癌的转移及预后评估中的临床应用价值。方法采用CanPatrolTM二代CTCs检测技术检测外周血CTCs计数及分型。41例经病理确诊的膀胱癌患者纳入研究,患者年龄33~83岁,男37例,女4例。肿瘤TNM分期:T1期15例、T2期12例、T3期9例、T4期5例、N1期6例、M1期3例。肿瘤组织病理分级:高级别膀胱癌30例、低级别膀胱癌11例。结果 41例膀胱癌患者总CTCs阳性率为68.29%(28/41),6例淋巴结转移患者中检出CTCs阳性2例,3例远处转移患者中检出CTCs阳性1例。本研究共检出CTCs 136个,其中上皮型CTCs 36个(26.5%)、混合型CTCs 70个(51.5%)、间质型CTCs 30个(22.0%);间质化CTCs 100个,占73.5%。30例高级别膀胱癌中CTCs检出20例,占66.7%,11例低级别膀胱癌中CTCs检出7例,占63.6%。13例CTCs阴性患者中,无淋巴结转移10例(69.23%),淋巴结转移3例(30.76%)。T1G3患者间质型CTCs阳性率为60.0%,CTCs总数≥3的患者比例为60.0%;T1G1~2患者间质型CTCs阳性率为20.0%,CTCs总数≥3的患者比例为20.0%。41例中29例患者术后获得随访,随访12~41个月,平均(13±2)个月,死亡8例。术后总生存率为72.41%,其中CTCs阳性者生存率为77.77%(14/18),CTCs阴性者生存率为63.60%(7/11)。结论 T1G3患者的间质型CTCs阳性率及CTCs总数≥3的患者比例明显高于T1G1~2患者。CTCs的总数及间质型CTCs的个数能够在一定程度上预测膀胱癌的恶性程度,并指导非肌层浸润性膀胱癌患者的早期治疗。CTCs的阳性检出率与膀胱癌的TNM分期、淋巴结转移、近期生存率之间未发现有明显相关性。Objective To detect circulating tumor cells （CTCs） and its types from peripheral blood in bladder cancer patients, and discuss TNM classification and its prognostic evaluation in clin- ical applications. Methods 41 patients, 37 males and 4 females, were pathologically diagnosed as bladder cancer and their ages ranged from 33 to 83. CanPatroITM second-generation technology was used to detect CTCs in peripheral blood. Tumor TNM staging： T1 in 15 cases; T2 in 12 cases; T3 in 9 cases; T4 in 5 cases NI in 6 cases; M1 in 3 cases. Tumor pathology classification： high-grade bladder cancer in 30 cases; low-grade bladder cancer in 11 cases. Results Of all 41 cases 68.29% （28/41） was positive for CTCs. 2 out of 6 cases of lymph node metastasis were CTCs positive, 1 out of 3 cases with distant metastasis was CTCs positive. Of 30 cases of high-grade bladder cancer 20 cases were CTCs positive （66.7%）, of 11 cases of low-grade bladder cancer 7 cases were CTCs positive （63.6%）. Of 13 patients who were CTCs negative, 10 patients have no lymph node metastases （69.23%）, and 3 patients with lymph node metastasis （30.76%）. In T1Ga patients, the positive rate of interstitial CTCs was 60%, the total number of CTCs3 in patients with positive rate： 60%. In T1 G1-2 （high-moderately differentiated） patients, the positive rate of interstitial CTCs was 20%, the total number of CTCs≥3 in patients with positive rate： 20%. 29 patients were followed up 12 to 41 months, an average of （13±2）months, 8 cases died. The overall survival rate was 72.41%. The positive survival rate of CTCs was 77.77% （14/18）, the negative survival rate of CTCs was 63.6% （7/11）. Conclusions The positive rate of interstitial CTCs and the total num her of CTCs in patients with T1 G3 was significantly higher than those in T1 G＇t-2 patients. The total number of CTCs and the number of interstitial CTCs can predict the degree of malignancy of bladder cancer to a certain extent and guide the early treat- ment of patients with

关 键 词：循环肿瘤细胞 膀胱癌 转移及预后评估 

分 类 号：R737.14[医药卫生—肿瘤]