肾细胞癌患者血液循环肿瘤细胞测定及临床意义  

Detection and clinical significance of circulating tumor cells in renal cell carcinoma patients

作　　者：张磊 周朝阳[1] 谭振琨 苏继峰[1] 胡鹏 李文泽[1] ZHANG Lei;ZHOU Chaoyang;TAN Zhenkun;SU Jifeng;HU Peng;LI Wenze(Department of Urology,First Peoples Hospital of Xiangtan,Xiangtan,Hunan,411101,China)

机构地区：[1]湘潭市第一人民医院泌尿外科,湖南湘潭411101

出　　处：《临床泌尿外科杂志》2020年第9期699-703,708,共6页Journal of Clinical Urology

摘　　要：目的:采用α-FR的配体探针PCR定量检测肾细胞癌(RCC)患者外周血循环肿瘤细胞(CTCs),并阐释该法测定RCC患者外周血CTCs的初步临床意义。方法:体外ACHN掺血回收实验评估α-FR的配体探针PCR技术检测外周血CTCs的有效性。将2017年2月-2019年10月在我院就诊的50例健康对照者、35例肾脏良性病变者及45例初诊RCC患者纳入本临床试验;RCC患者分为术前、术后两组。采集入组者外周静脉血4 mL(RCC患者于术前1 d、术后7 d采血2次),用上述方法定量检测CTCs。结果:ACHN掺血回收实验提示本方法的检测值同掺入已知数量肿瘤细胞具有很高的相关性(r=0.99),RCC术前组外周血CTCs水平显著高于健康对照组和肾脏良性病变组(P<0.01,P<0.01),并且RCC患者CTCs水平同肿瘤的TNM分期、临床分期显著相关(P<0.01),根治性肾切除术和保留肾单位手术对于T1、T2期不伴转移RCC患者术后外周血CTCs水平的影响无差异(P=0.320)。结论:采用α-FR的配体探针PCR能有效检测RCC患者外周血CTCs,本方法定量检测CTCs可弥补肾癌TNM分期的不足,可能在评估RCC患者治疗效果和监测肿瘤进展方面具有一定的价值。Objective: To quantitatively detect circulating tumor cells(CTCs) from renal cell carcinoma(RCC) patients using "ligand probe" PCR technology based on α-FR, and then demonstrate its preliminary clinical significance. Method: The efficacy of "ligand probe" PCR method for CTCs detection was verified by artificial spiking experiments with human RCC line ACHN. Fifty health volunteers, 35 benign lesions of the kidney patients and 45 RCC patients were enrolled in our clinical trials, and then those RCC patients were divided into preoperative and postoperative group. Four mL peripheral blood was collected from all enrolled recruiters(twice for RCC patients: 1 day before operation and 7 days after operation), and the above technology was applied to quantitatively detect CTCs. Result: Our artificial spiking experiment yielded a high degree correlation coefficient(r=0.99) between the defined amounts of ACHN cells and the detection value. CTCs detection value in pre-operation of RCC was significantly higher than that of healthy controls and renal benign lesions group(P<0.01, P<0.01). Also it was significantly correlated with tumor TNM stage and clinical stage(P<0.01). However, for T1, T2 and non-metastasis RCC patients undergoing radical nephrectomy or nephron sparing surgery, no significant difference was found in post-operation peripheral blood CTCs levels(P=0.320). Conclusion: The "ligand probe" PCR technology could efficiently detect CTCs from peripheral blood for RCC patients. In our study, the technology of CTCs quantitative detection for RCC patients could remedy defects of TNM staging, and it may have some value in evaluating therapy effects and monitoring tumor progression.

关 键 词：α型叶酸受体 循环肿瘤细胞 肾细胞癌 TNM分期 

分 类 号：R737.11[医药卫生—肿瘤]