胃癌患者外周血中CD45^–CD44^+CD54^+细胞亚群含量及其临床意义  

The number of CD45^–CD44^+CD54^+cell subsets in peripheral blood of gastric cancer patients and its clinical significance

作　　者：张东阳 陈小龙[1] 宋小海[1] 张世姣 张维汉[1] 刘凯[1] 黄巧容[3] 孟文彤[3] 杨昆[1] 陈心足[1] 莫显明[3] 胡建昆[1] ZHANG Dongyang;CHEN Xiaolong;SONG Xiaohai;ZHANG Shijiao;ZHANG Weihan;LIU Kai;HUANG Qiaorong;MENG Wentong;YANG Kun;CHEN Xinzu;MO Xianming;HU Jiankun(Department of Gastrointestinal Surgery and Laboratory of Gastric Cancer,Chengdu 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu 610041,P.R.China;Laboratory of Stem Cell Biology,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院胃肠外科中心/胃癌研究室,成都610041 [2]四川大学华西临床医学院,成都610041 [3]四川大学华西医院干细胞生物学研究室,成都610041

出　　处：《中国普外基础与临床杂志》2020年第4期434-441,共8页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金青年科学基金项目(项目编号:81702366);四川省科技厅重点研发项目(项目编号:2019YFS0255);四川省干部保健科研课题(项目编号:川干研2017-114);华西医院学科卓越发展1.3.5工程(项目编号:ZY2017304)。

摘　　要：目的以胃癌肿瘤干细胞标志物CD44和CD54为靶点,利用流式细胞术检测胃癌患者外周血中CD45~–CD44^+CD54^+细胞亚群含量,并结合临床病理学特征分析其临床意义。方法纳入2016年12月至2017年9月期间四川大学华西医院胃肠外科38例胃癌患者作为研究对象,利用流式细胞术检测其外周血中CD45~–CD44^+CD54^+细胞亚群含量,并分析其临床意义。结果 38例患者的CD45~–CD44^+CD54^+细胞中位数为541.9个/mL(71.7~8 057.0个/mL),其中R0组为555.9个/mL(71.7~8 057.0)个/mL。CD45~–CD44^+CD54^+细胞中位数TNMⅠ–Ⅱ期患者为858.6个/mL(183.5~8 057.0个/mL),高于TNMⅢ–Ⅳ期患者的364.6个/mL(71.7~2 269.7个/mL),P=0.015;N0组为941.4个/mL(183.5~8 057.0个/mL,高于N^+组的379.3个/mL(71.7~2 269.7个/mL),P=0.002。T3–4期(P=0.025)、N^+期(P=0.009)和TNMⅢ–Ⅳ期(P=0.012)的患者中CD45~–CD44^+CD54^+高细胞量亚组所占比例较低。联合CD45~–CD44^+CD54^+细胞量和肿瘤大小可以对N分期和TNM分期做出更准确的判断,但其与其他临床病理学特征和预后无显著相关。结论 CD45~–CD44^+CD54^+细胞亚群数量与肿瘤进展之间有相关性,可能用于判断TNM分期和N分期,但本研究纳入样本较少,仍需扩大样本论证其在胃癌患者中的临床意义。Objective CD44 and CD54 are two specific biomarkers of gastric cancer stem cells and were used as targets in this study.The number of CD45–CD44+CD54+cell subsets in peripheral blood of gastric cancer patients was detected by flow cytometry.Further,we combined these results with the clinicopathological characteristics of gastric cancer patients to analyze the significance of CD45–CD44+CD54+cell subsets.Methods From December 2016 to September 2017,38 patients with gastric cancer in gastrointestinal surgery of West China Hospital of Sichuan University were included as the study object.The content of CD45–CD44+CD54+cell subsets in their peripheral blood was detected by flow cytometry and its clinical significance was analyzed.Results The median number of CD45–CD44+CD54+cells were 541.9/mL(71.7–8057.0/mL)in 38 patients and 555.9/mL(71.7–8057.0/mL)in the group of patients with R0 resection.Patients without lymph node metastasis were found to have more CD45–CD44+CD54+cells than patients with lymph node metastasis[941.4/mL(183.5–8057.0)/mL vs 379.3/mL(71.7–2269.7/mL,P=0.002],and more CD45–CD44+CD54+cells in patients with TNM stageⅠ–Ⅱthan in TNM stageⅢ–Ⅳ[858.6/mL(183.5–8057.0/mL)vs 364.6/mL(71.7–2269.7/mL,P=0.015].The patients with T3–4 stages(P=0.025),N+stage(P=0.009)and TNMⅢ–Ⅳstage(P=0.012)had low ratios of the subgroup with high number of CD45–CD44+CD54+cells,respectively.We made a more accurate judgment of N stage and TNM stage when we combined tumor size and the number of CD45–CD44+CD54+cells together.However,there was no significant correlation between the number of CD45–CD44+CD54+cells and other clinicopathological features and prognosis.Conclusions The number of CD45–CD44+CD54+cell subsets is correlated with tumor progression,which might be used to predict TNM stage and N stage.However,the number of patients included in this study is too small,and the clinical significance of CD45–CD44+CD54+subsets in gastric cancer patients needs to be further demonstrated by

关 键 词：胃癌 循环肿瘤细胞 肿瘤进展 

分 类 号：R735.2[医药卫生—肿瘤]