外周血循环肿瘤细胞检测在局部晚期头颈部鳞状细胞癌中的应用  

Peripheral blood circulating tumor cells in local advanced head and neck squamous cell carcinoma

作　　者：楼建林[1] 郭良[1] 郑伟慧[1] 赵佳正[1] 赵坚强[1] 梁忠[1] 王升晔[2] 方美玉[3] 

机构地区：[1]浙江省肿瘤医院头颈外科,杭州310022 [2]浙江省肿瘤医院放射治疗科,杭州310022 [3]浙江省肿瘤医院综合肿瘤内科,杭州310022

出　　处：《中华耳鼻咽喉头颈外科杂志》2017年第11期824-829,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：浙江省医药卫生重大科技计划省部共建重点项目（WKJ.1712）;浙江省医药卫生科技计划项目（2015KYA036、2017KY029）

摘　　要：目的 探讨外周血循环肿瘤细胞（circulating tumor cell,CTC）检测在局部晚期头颈部鳞状细胞癌（locally advanced head and neck squamous cell carcinoma,LAHNSCC）中的临床应用价值.方法 收集2016年4—12月20例LAHNSCC患者的临床资料,同时取8名健康人作为阴性对照,采用CytoSorter循环肿瘤细胞（CTC）分选系统,通过特异性抗体纳米微流控芯片免疫捕获对LAHNSCC CTC进行富集,然后使用免疫荧光染色法对CTC进行鉴定,分析CTC与肿瘤临床病理特征的关系;在诱导化疗后、治疗结束后2周分别进行动态检测,比较CTC变化情况.结果 8名健康人均未检测到CTC;20例LAHNSCC患者治疗前CTC检出率达到75%（15/20）,平均22.4颗.CTC水平与不同年龄段及淋巴结N分期具有相关性,CTC水平在不同年龄段（〈60岁与≥60岁）之间比较差异有统计学意义（P=0.032）,淋巴结分期N2＋N3的患者较N0＋N1的患者CTC高,差异有统计学意义（P=0.023）.13例患者诱导化疗后再次行CTC检测,均检出CTC,平均9.5颗;14例患者全部治疗结束后行CTC检测,10例检出CTC,平均1.6颗;诱导化疗后及治疗结束后CTC数量均明显减少,治疗结束后CTC检出率接近基线值.治疗前后比较,差异有统计学意义.结论 CTC在LAHNSCC外周血中具有较高的检出率;年龄≥60岁组与N分期≥N2者治疗前CTC检出水平较高;不同治疗阶段行CTC实时动态检测差异有统计学意义,有望辅助评估诱导化疗与总体疗效.Objective To investigate the value of detecting circulating tumor cells （ CTCs ） in patients with local advanced head and neck squamous cell carcinoma （ LAHNSCC ） .Methods Twenty cases of LAHNSCC and eight healthy cases as the negative control were collected .The clinicopathological factors were evaluated . The LAHNSCC CTCs were enriched by specific antibody nanofluidic chip immunoassay using CytoSorter CTCs sorting system .LAHNSCC CTCs were identified by immunofluorescence staining.The relationships between CTCs and the clinicopathological features of LAHNSCC were analyzed . The numbers of CTCs were monitored and compared two weeks after inductive chemotherapy and at the end of the treatment.Results CTCs were detect in 15 （75%） 20 patients with LASHNCC, with an average number of 22.4 CTCs.There was a correlation between the numbers of CTCs and age or N staging （ P〈0.05）.Among the 15 cases with CTCs, 13 cases received inductive chemotherapy , for whom CTCs were detected again after inductive chemotherapy in all of these 13 patients, with an average number of 9.5 CTCs. Ten of the fourteen cases （71.4%） were still CTCs detected After whole treatments CTCs were detected in＆nbsp;14 patients, of them, 10 （71.4%） patients showed positive CTCs , with an average 1.6 CTCs.The numbers of CTCs decreased after either inductive chemotherapy or the whole treatment .The number of detected CTCs after whole treatment decreased nearly to background levels .Conclusions CTCs have a high detection rate in the peripheral blood of patients with LAHNSCC , especially in patients ≥60 years old and with ≥ N2 stage before treatment .Real-time detection of dynamic change of CTCs may assist to evaluate therapeutic effect.

关 键 词：肿瘤细胞 循环 头颈部肿瘤 癌 鳞状细胞 诱导化疗 

分 类 号：R739.91[医药卫生—肿瘤]