循环肿瘤细胞异倍体检测在鼻咽癌患者治疗和预后中的临床意义  

Clinical significance of circulating tumor cell aneuploidy detection in the treatment and prognosis of patients with nasopharyngeal carcinoma

作　　者：汪玉兰 胡烨 赵国旗[1] 龚燕萍[1] 谢剑竹 胡玢婕 黄倩[1] 程进[1] WANG Yulan;HU Ye;ZHAO Guoqi;GONG Yanping;XIE Jianzhu;HU Binjie;HUANG Qian;CHENG Jin(Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China)

机构地区：[1]上海交通大学附属第一人民医院肿瘤中心,上海201620

出　　处：《临床肿瘤学杂志》2022年第4期372-377,共6页Chinese Clinical Oncology

基　　金：国家自然科学基金面上项目(81972887)。

摘　　要：目的探讨鼻咽癌(NPC)患者外周血循环肿瘤细胞(CTC)变化与治疗效果和预后的关系。方法回顾性分析在本院接受同步放化疗的35例NPC者,采用两两配对样本的非参数检验法分析患者治疗前后的CTC数目差异。根据细胞形态大小将CTC分为大细胞CTC和小细胞CTC,根据8号染色体数目分为三倍体、四倍体和多倍体(五倍体及以上)三类,比较患者治疗前后大小细胞差异与患者疗效的关系。以无进展生存期为预后评价指标,采用Kaplan-Meier法分析患者治疗前后CTC差值与预后的关系。结果NPC患者治疗前后CTC变化与年龄、性别、TNM分期、WHO分型、外周血EB病毒抗体和转移情况无关(P>0.05)。在部分缓解患者中,同步放化疗后CTC水平有所下降,特别是三倍体和四倍体的小细胞CTC下降明显(P<0.05)。治疗前后三倍体CTC差值与预后相关且差异有统计学意义(P<0.05)。结论NPC患者外周血CTC亚型水平与患者疗效和预后相关,动态监测患者外周血CTC水平对于NPC治疗指导和预后预测具有一定的临床意义。Objective To explore the relationship of circulating tumor cell(CTC)number changes in peripheral blood of nasopharyngeal carcinoma(NPC)patients with treatment efficacy and prognosis.Methods Thirty-five patients with NPC who received concurrent chemoradiotherapy in our hospital were retrospectively analyzed,and the difference in the number of CTC before and after treatment was analyzed by pairwise paired nonparametric test.CTCs were categorized into large and small cell CTCs according to the cell size or triploid,tetraploid,and polyploid according to the number of chromosome 8.The relationship between the difference of cell size before and after treatment and the efficacy was explored.Progress-free survival was chosen as the primary outcome,and Kaplan-Meier method was used to analyze the relationship between prognosis and CTC difference between post-and pre-treatment.Results Changes of CTC before and after treatment had no association with age,sex,TNM stage,WHO pathological classification,EB virus antibody in peripheral blood and metastasis in NPC patients(P>0.05).In patients with partial remission,CTC levels decreased after concurrent chemoradiotherapy,especially the triploid and tetraploid small cells with significant difference(P<0.05).Moreover,the difference of triploid CTC before and after treatment was associated with prognosis,and the difference between both groups was statistically significant(P<0.05).Conclusion The peripheral blood CTC subtypes are related to the efficacy and prognosis of patients with NPC.Dynamic monitoring of the CTC level has certain clinical significance for the treatment and prognosis of NPC.

关 键 词：鼻咽癌 循环肿瘤细胞 异倍体细胞 疗效评估 

分 类 号：R739.6[医药卫生—肿瘤]