外周血循环肿瘤细胞检测与胰腺癌化疗反应及肿瘤复发转移的关系  

Relationship between circulating tumor cells in peripheral blood and chemotherapy response,tumor recurrence and metastasis of pancreatic cancer

作　　者：刘娇[1] 卢熹微 曹军丽[1] 郑磊[1] 徐红梅[1] LIU Jiao;LU Xiwei;CAO Junli;ZHENG Lei;XU Hongmei(Department of Oncology,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院肿瘤科,河北秦皇岛066000

出　　处：《西部医学》2022年第9期1356-1360,共5页Medical Journal of West China

基　　金：秦皇岛市重点研发计划科技支撑项目(202004A106)。

摘　　要：目的分析外周血循环肿瘤细胞(CTCs)检测与胰腺癌化疗反应、肿瘤复发转移的关系。方法选取2018年2月~2019年10月我院收治的胰腺癌患者100例及同期健康体检者与胰腺良性疾病患者各30例为研究对象,检测其外周血CTCs表达情况,术后随访记录胰腺癌患者肿瘤复发转移及生存情况,分析CTCs表达与胰腺癌患者临床特征、化疗疗效及肿瘤复发转移的关系。结果胰腺癌组CTCs阳性率明显高于良性疾病组与对照组(P<0.05);肿瘤分期Ⅲ~Ⅳ期、低分化患者CTCs阳性率明显高于Ⅰ~Ⅱ期、高/中分化患者(P<0.05);Logistic回归分析显示,胰腺癌患者肿瘤分期、分化程度与CTCs阳性有关(P<0.05);化疗客观缓解42例(42.00%),疾病控制71例(71.00%),疾病控制患者术后CTCs阳性率明显低于疾病进展患者(P<0.05);Kaplan-Meier生存分析发现,术后CTCs阳性患者1年生存率明显低于CTCs阴性患者(χ^(2)=5.114,P=0.024),CTCs阳性患者1年内复发转移率明显高于CTCs阴性患者(χ^(2)=4.479,P=0.034)。结论外周血CTCs表达情况与胰腺癌肿瘤分期、分化程度密切相关,术后CTCs阳性患者化疗疗效较差,存在更高肿瘤复发转移及死亡风险。Objective To analyze the relationship between circulating tumor cells(CTCs)in peripheral blood and chemotherapy response,tumor recurrence and metastasis of pancreatic cancer.Methods 100 patients with pancreatic cancer,30 healthy individuals and 30 patients with benign pancreatic diseases were enrolled.The expression of CTCs in peripheral blood was detected.Tumor recurrence and metastasis,and survival of patients with pancreatic cancer during postoperative follow-up were recorded.The relationship between CTCs expression and clinical characteristics of pancreatic cancer patients,chemotherapy efficacy,tumor recurrence,metastasis were analyzed.Results The positive rate of CTCs in pancreatic cancer group was significantly higher than that in benign disease group and that in control group(P<0.05).The positive rates of CTCs in patients in tumor stageⅢ-Ⅳand with poor differentiated tumors were significantly higher than those in patients in tumor stageⅠ-Ⅱand with highly/moderately differentiated tumors(P<0.05).Logistic regression analysis showed that tumor staging and differentiation degree were related to CTCs positive in patients with pancreatic cancer(P<0.05).There were 42 cases(42.00%)with objective remission and 71 cases(71.00%)with disease under control by chemotherapy.The positive rate of CTCs in patients with disease control was significantly lower than that with disease progression(P<0.05).It was found by Kaplan-Meier survival analysis that the 1-year survival rate in CTCs positive patients was significantly lower than that in CTCs negative patients(χ^(2)=5.114,P=0.024),and recurrence metastasis rate within 1 year was significantly higher than that in CTCs negative patients(χ^(2)=4.479,P=0.034).Conclusion The expression of CTCs in peripheral blood is closely related to tumor staging and differentiation degree of pancreatic cancer.The chemotherapy effect is relatively worse in CTCs positive patients after surgery,and there are higher risks of tumor recurrence,metastasis and death.

关 键 词：胰腺癌 循环肿瘤细胞 化疗 复发 转移 

分 类 号：R735[医药卫生—肿瘤]