循环肿瘤细胞用于肝细胞癌微血管侵犯术前预测的初步探索  

Exploration of circulating tumor cell for preoperative prediction of microvascular invasion in hepatocellular carcinoma

作　　者：伍隽华 陈云扬 王恺[1] 邝乃乐[2] 左超海[2] 黄皓川 余杰雄[2] 周杰[1] Wu Juanhua;Chen Yunyang;Wang Kai;Kuang Naile;Zuo Chaohai;Huang Haochuan;Yu Jiexiong;Zhou Jie(Division of Hepatobiliopancreatic Surgery,Department of General Surgery,Nanfang Hospital,Southern Medical University,Guangdong Guangzhou 510515,China;Department of Hepatobiliary,Pancreatic and Splenic Surgery,Jiangmen Central Hospital,Guangdong Jiangmen 529000,China)

机构地区：[1]南方医科大学南方医院普通外科学肝胆胰外科,广东广州510515 [2]江门市中心医院肝胆胰脾外科,广东江门529000

出　　处：《腹部外科》2023年第4期307-312,共6页Journal of Abdominal Surgery

基　　金：广东省医学科学技术研究基金(A2020602);江门市中心医院科研杰青项目(J201902);江门市中心医院科研启动基金项目(D201902)。

摘　　要：目的初步探索循环肿瘤细胞(circulating tumor cell,CTC)在术前预测肝细胞癌发生微血管侵犯(microvascular invasion,MVI)的应用价值。方法回顾性收集2020年1月至2021年10月在江门市中心医院接受根治性手术切除的108例原发性肝细胞癌病人的临床资料,所有病人术前均行CTC检测。筛选出肿瘤术后复发、发生MVI的高危因素,通过受试者工作特征(receiver operating characteristic,ROC)曲线分析术前CTC水平对MVI的预测效能。结果MVI阳性是肝细胞癌术后复发的高危因素(P<0.05)。MVI阳性组病人术前的总CTC、混合型循环肿瘤细胞及间质型循环肿瘤细胞数目均高于MVI阴性组病人,差异均具有统计学意义(均P<0.05),其中术前总CTC>3个/5 mL是肝细胞癌发生MVI的高危因素。ROC分析显示,术前总CTC预测肝细胞癌发生MVI的ROC曲线下面积为0.683,其诊断MVI的灵敏度和特异度分别为66.7%、62.1%。结论MVI阳性是肝细胞癌术后复发的高危因素,术前CTC检测可为预测肝细胞癌是否发生MVI提供参考。Objective To explore the application value of circulating tumor cell(CTC)in predicting microvascular invasion(MVI)in hepatocellular carcinoma(HCC).Methods A total of 108 HCC patients undergoing radical surgery and CTC detection were recruited.The risk factors of postoperative recurrence and MVI were examined.The prediction value for the risk of MVI was analyzed by the curve of receiver operating characteristic(ROC).Results MVI positivity was a risk factor for postoperative recurrence of HCC.The number of total CTC(TCTC),hybrid circulating tumor cell(HCTC)and mesenchymal circulating tumor cell(MCTC)were significantly higher in MVI positive group than that in MVI negative group(P<0.05).Preoperative TCTC>3/5 mL was a high risk factor for MVI.ROC analysis indicated that the area under curve(AUC)of TCTC for predicting MVI in HCC was 0.683.Sensitivity and specificity was 66.7%and 62.1%respectively.Conclusion MVI is a high risk factor for postoperative recurrence of HCC.And preoperative CTC detection provides references for predicting MVI of HCC.

关 键 词：肝细胞癌 复发 微血管侵犯 循环肿瘤细胞 

分 类 号：R657.3[医药卫生—外科学]