循环肿瘤细胞及纤维蛋白原在评估头颈部肿瘤预后中的作用  

Role of circulating tumor cells and fibrinogen in evaluating the prognosis of head and neck tumors

作　　者：由伟 王福光[1] 鞠再双[1] 王喆[1] 周东 孙丽娟[1] 王若雨[1] YOU Wei;WANG Fuguang;JU Zaishuang;WANG Zhe;ZHOU Dong;SUN Lijuan;WANG Ruoyu(Department of Oncology,Affiliated Zhongshan Hospital of Dalian University,Dalian 116000,China)

机构地区：[1]大连大学附属中山医院肿瘤科,辽宁大连116000

出　　处：《大连医科大学学报》2020年第5期410-418,共9页Journal of Dalian Medical University

摘　　要：目的探讨循环肿瘤细胞(circulating tumor cells,CTCs)及纤维蛋白原(fibrinogen,FIB)与头颈部肿瘤临床病理参数关系,以及对判断头颈部肿瘤患者生存及预后的价值。方法回顾性分析2014年10月至2018年7月在大连大学附属中山医院经病理确诊的79例Ⅰ~Ⅳ期头颈部肿瘤患者的详细临床资料。分析CTCs及FIB表达与性别,年龄,吸烟,饮酒,病理类型,T、N分期,部位,TNM分期,是否手术,辅助治疗方式的关系;分析CTCs及FIB表达对患者预后及无病生存期(disease-free survival,DFS)的影响;分析CTCs及FIB表达的相关性。结果79例患者中CTCs阳性24例,阳性率30.37%。CTCs水平与性别,年龄,吸烟,饮酒,病理类型,T、N分期,部位,TNM分期,是否手术无关(P>0.05),与辅助治疗方式有关(P<0.05);FIB水平与性别、年龄、吸烟、饮酒、部位、病理类型、是否手术、辅助治疗、肿瘤分期无关(P>0.05);Cox回归分析表明放疗及FIB水平是影响头颈部肿瘤患者预后的独立因素(P<0.05);Kaplan-Meier生存分析表明术后64例头颈肿瘤患者中CTCs阴性组DFS(31±2.8)个月,CTCs阳性组DFS(27±4.2)个月,两组比较差异无统计学意义(P>0.05);低FIB组DFS(35±2.4)个月,高FIB组DFS(28±4.3)个月,两组比较差异无统计学意义(P>0.05);术后23例Ⅰ~Ⅱ期患者中,CTCs阴性组DFS(34±2.7)个月,CTCs阳性组(31±1.2)个月,两组比较差异亦无统计学意义(P>0.05);低FIB组DFS(39±2.7)个月,高FIB组DFS(19±6.6)个月,两组比较差异亦无统计学意义(P>0.05);术后41例Ⅲ~Ⅳ期患者中,CTCs阳性组DFS(32±4.3)个月,CTCs阴性组DFS(30±3.6)个月,两组比较差异无统计学意义(P>0.05);高FIB组DFS(30±4.7)个月,低FIB组DFS(29±3.1)个月,两组比较差异无统计学意义(P>0.05)。52例患者行术后辅助治疗患者中,CTCs阳性组DFS(32±4.3)个月,CTCs阴性组DFS(31±3.3)个月,两组比较差异无统计学意义(P>0.05);低FIB组DFS(34±3.0)个月,高FIB组DFS(27±4.5)个月,两组比较差异无统计学�Objective To explore the relationship between circulating tumor cells(CTCs)and fibrinogen(FIB)and clinicopathological parameters of head and neck tumors,as well as their value in the evaluation of patients’survival and prognosis.Methods A retrospective analysis was performed on the detailed clinical data of 79 patients,who were diagnosed pathologically with stageⅠ-Ⅳhead and neck tumors at the Affiliated Zhongshan Hospital of Dalian University from October 2014 to July 2018.The relationship between CTCs and FIB expression and gender,age,smoking,alcohol consumption,pathological type,location,TNM stage,surgical or adjuvant therapy was analyzed.The effects of CTCs and FIB expression on prognosis and DFS were evaluated.The correlation between CTCs and FIB expression was studied.Results Among 79 patients,24 were positive for CDCs with a positive rate of 30.37%.The level of CTCs was not related to gender,age,smoking,alcohol consumption,pathological type,location,TNM stage,and surgery(P>0.05),but was related to adjuvant therapy(P<0.05).Fibrinogen level was not correlated with gender,age,smoking,drinking,pathological type,surgery,adjuvant therapy,and tumor stage(P>0.05).Cox regression analysis revealed that radiotherapy and fibrinogen level were independent prognostic factors for head and neck cancer patients(P<0.05).Kaplan-Meier survival analysis showed that among the 64 patients with head and neck tumor,the CTCs-negative group had DFS(31±2.8)months and the CTCs-positive group(27±4.2)months after surgery,the difference between the two groups was not statistically significant(P>0.05).DFS in the low FIB group was(35±2.4)months,while that in the high FIB group was(28±4.3)months.There was no significant difference between the two groups(P>0.05).Among the 23 patients with stageⅠ-Ⅱtumor,the DFS of the CTCs-negative group was(34±2.7)months,while that of the CTCs-positive group was(31±1.2)months after surgery.There was no statistically significant difference between the two groups(P>0.05).The DFS of the low FIB g

关 键 词：循环肿瘤细胞 纤维蛋白原 头颈部肿瘤 放疗 预后 

分 类 号：R73[医药卫生—肿瘤]