循环肿瘤细胞及干细胞检测在Lynch综合征家系结直肠癌筛查中的应用价值  

Clinical value of detection of circulating tumor cell and circulating tumor stem cell in colorectal cancer screening in Lynch syndrome family

作　　者：李贵[1] 胡桂明[2] 董峰[1] 孙趁意[1] Li Gui;Hu Guiming;Dong Feng;Sun Chenyi(Department of Gastroenterology Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China;Department of Pathology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院消化内科,450014 [2]郑州大学第二附属医院病理科,450014

出　　处：《中国实用医刊》2019年第24期4-8,共5页Chinese Journal of Practical Medicine

基　　金：河南省高等学校重点科研项目计划(19B320020)。

摘　　要：目的 探讨循环肿瘤细胞(CTC)及循环肿瘤干细胞(CTSC)检测在Lynch综合征家系结直肠癌(CRC)筛查的临床价值。方法 抽取2012年12月至2018年12月郑州大学第二附属医院Lynch综合征家系CRC患者76例为研究对象,患者入院后采集临床信息并完善相关检查,然后择期进行手术治疗,并于手术前后分别采集空腹外周静脉血15 ml检测CTC和CTSC,分析外周血CTC和CTSC检测结果及其阳性率与患者分期和预后的关系。结果 76例Lynch综合征家系CRC患者外周血中检测出CTC数量术前为4.6(0~117)个/7.5 ml,术后为4.9(0~124)个/7.5 ml,CTSC1数量术前为0.7(0~28)个/7.5 ml,术后为0.6(0~29)个/7.5 ml,CTSC2数量术前为0.1(0~14)个/7.5 ml,术后为0.1(0~16)个/7.5 ml,CTSC3数量术前和术后均为0;CTC、CTSC1和CTSC2手术前后阳性率分别为40.79%和46.05%(P>0.05)、43.42%和42.11%(P>0.05)、3.95%和5.26%(P>0.05);不同TNM分期、N分期和M分期的Lynch综合征家系CRC患者手术前后外周血CTC阳性率比较差异有统计学意义(P<0.05);不同M分期的Lynch综合征家系CRC患者手术前后外周血CTSC1阳性率比较差异有统计学意义(P<0.05);复发患者术前、术后CTC和CTSC阳性率高于未复发者(P<0.05)。结论 对Lynch综合征家系CRC患者进行CTC和CTSC检测有利于辅助判断肿瘤生物学行为,提升临床分期准确性,从而为评估肿瘤转移和术后复发提供参考依据,对CRC诊断、治疗、病情监测和预后评估均具有指导意义。Objective To study the clinical value of detection of circulating tumor cell(CTC)and circulating tumor stem cell(CTSC)in the colorectal cancer(CRC)screening in Lynch syndrome family.Methods A total of 76 patients with CRC from Lynch syndrome family in the Second Affiliated Hospital of Zhengzhou University from December 2012 to December 2018 were selected for the study.The clinical information were collected form all patients after admission,and the related examinations were performed.And then the patients were given selective surgery,and the 15 ml fasting peripheral venous blood was collected before and after operation to detect the CTC and CTSC.And the relationship between detection resultsandpositive ratesof peripheral blood CTC and CTSCand patientstaging and prognosis was analyzed.Results In peripheral blood of 76 patients with CRC from Lynch syndrome family,the number of CTCs was 4.6(0-117)/7.5 ml before operation and 4.9(0-124)/7.5 ml after operation,and the number of CTSC1 was 0.7(0-28)/7.5 ml before operation and 0.6(0-29)/7.5 ml after operation,and the number of CTSC2 was 0.1(0-14)/7.5 ml before operation and 0.1(0-16)/7.5ml after operation,and the number of CTSC3 was 0 before operation and after operation.The positive rates of CTC,CTSC1 and CTSC2 before and after operation were 40.79%and 46.05%(P>0.05),43.42%and 42.11%(P>0.05),3.95%and 5.26%(P>0.05).There were statistically significant differences in the CTC positive rates before and after operation in peripheral blood of patients with CRC from Lynch syndrome family in different TNM stages,N stages and M stages(P<0.05).There were statistically significant differences in the CTSC1 positive rates before and after operation in peripheral blood of patients with CRC from Lynch syndrome family in different M stages(P<0.05).The positive rates of CTC and CTSC before and after operation in patients with recurrence were significantly higher than those in patients without recurrence(P<0.05).Conclusions The detection of CTC and CTSC in patients with CRC from Lynch s

关 键 词：Lynch综合征家系 结直肠癌筛查 循环肿瘤细胞 循环肿瘤干细胞 

分 类 号：R735[医药卫生—肿瘤]