循环肿瘤细胞在胃癌临床分期判断、疗效监测及预后评估中的价值  

Value of circulating tumor cells in clinical staging,curative effect monitoring,and prognostic evaluation of gastric cancer

作　　者：刘霞 董丽娟[1] 张军鹏[1] 贺继东[1] 薛海兰[2] 王顺[2] LIU Xia;DONG Li-juan;ZHANG Jun-peng;HE Ji-dong;XUE Hai-lan;WANG Shun(Department of Gastroenterology,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA;Department of Clinical Laboratory,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区：[1]宝鸡市人民医院消化内科,陕西宝鸡721000 [2]宝鸡市人民医院检验科,陕西宝鸡721000

出　　处：《海南医学》2020年第22期2915-2918,共4页Hainan Medical Journal

摘　　要：目的探讨外周血循环肿瘤细胞(CTCs)在胃癌临床分期判断、疗效监测及预后评估中的临床价值。方法选取2015年6月至2017年6月于宝鸡市人民医院消化内科诊治的130例胃癌患者(胃癌组)和40例健康体检者(对照组)作为研究对象。利用CanPatrolTM CTC-二代捕获技术检测外周血CTCs,并根据上皮-间质转化(EMT)理论进行CTC分型,分析CTCs数目及分型与胃癌临床分期、疗效及预后的关系。结果对照组中,CTCs检测均为阴性;胃癌组中,CTCs阳性者117例(90.0%),其中CTCs均数为5(0~42):上皮型均数为1.8(0~20)、混合型均数为3.5(0~42)和间质型均数为1.5(0~8);CTCs检出率在不同T分期、N分期和AJCC分期方面比较差异均有统计学意义(P<0.05);CTCs分型在不同N分期和AJCC分期方面比较差异均有统计学意义(P<0.05),但不同T分期比较差异无统计学意义(P>0.05);术前、术后胃癌患者CTCs检出率和CTCs分型比较差异均有统计学意义(P<0.05);随访3年,截至随访终止日期,所有胃癌患者均未失访;117例CTCs阳性胃癌患者中45例进展,72例未进展;40例死亡,77例生存;13例CTCs阴性胃癌患者中,2例进展,11例未进展;1例死亡,12例生存;CTCs阴性胃癌和CTCs阳性胃癌患者的无进展生存率(85%vs 62%)和总生存率(92%vs 66%)比较差异有统计学意义(P<0.05);CTCs阳性胃癌患者中,CTCs上皮型、混合型和间质型的无进展生存率(84%vs 69%vs 32%)和总生存率(94%vs 73%vs 32%)比较差异均有统计学意义(P<0.05)。结论胃癌患者CTCs检出率高,且具有不同分型,CTCs与临床分期、疗效及预后密切相关。Objective To discuss the value of peripheral blood circulating tumor cells(CTCs)in clinical staging,curative effect monitoring,and prognosis evaluation of gastric cancer.Methods A total of 130 patients with gastric cancer(gastric cancer group)and 40 cases of healthy controls for physical examination(healthy control group)who were treated in Baoji People's Hospital from June 2015 to June 2017 were selected as the study subjects.The circulating tumor cells in peripheral blood was detected by CanPatrolTM CTC technique(2nd generation).CTC typing was performed according to the theory of epithelial-mesenchymal transformation(EMT).The relationship between the number and typing of CTCs and clinical stage,curative effect,and prognosis of gastric cancer was analyzed.Results In the healthy control group,CTCs were negative,and in the gastric cancer group,117 cases(90.00%)were CTCs positive,of which the mean CTCs were 5(0 to 42):epithelial type 1.8(0 to 20),mixed type 3.5(0 to 42),and interstitial type 1.5(0 to 8).The detection rate of CTCs in different T stages,N stages,and AJCC stages had significant difference(P<0.05).CTCs classification in different N stages and AJCC stages had significant difference(P<0.05),but there was no significant difference in different T stages(P>0.05).There were significant differences in CTCs detection rate and CTCs classification of gastric cancer patients before and after operation(P<0.05).All the gastric cancer patients were followed up for 3 years.Among the 117 cases of CTCs-positive gastric cancer:45 cases progressed,72 cases did not progress;40 cases died,77 cases survived.Among the 13 cases of CTCs-negative gastric cancer:2 cases progressed,11 cases did not progress;1 case died,12 cases survived.There were significant differences in progression-free survival rate and overall survival rate between CTCs-negative gastric cancer patients and CTCs-positive gastric cancer patients(P<0.05):85%vs 62%,92%vs 66%.In patients with CTCs-positive gastric cancer,there was significant difference in progr

关 键 词：胃癌 外周血循环肿瘤细胞 临床分期 疗效 无进展生存率 总生存率 

分 类 号：R735.2[医药卫生—肿瘤]