循环肿瘤细胞和循环肿瘤内皮细胞对鼻咽癌治疗的应答变化及其意义  

Response of circulating tumor cells and circulating tumor endothelial cells to treatment modalities of nasopharyngeal carcinoma and its significance

作　　者：詹伟艺 何金兰[1] 陈念永[1] ZHAN Weiyi;HE Jinlan;CHEN Nianyong(Division of Head&Neck Tumor Multimodality Treatment,Cancer Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院肿瘤中心头颈肿瘤病房,成都610041

出　　处：《华西医学》2024年第2期245-250,共6页West China Medical Journal

摘　　要：目的 探究鼻咽癌患者各治疗阶段循环肿瘤细胞(circulating tumor cell, CTC)及循环肿瘤内皮细胞(circulating tumor endothelial cell, CTEC)与治疗方式的关系。方法 回顾性收集2016年3月-2019年11月在四川大学华西医院就诊的不同治疗阶段鼻咽癌患者,通过差相富集-瘤标免疫荧光染色-染色体原位杂交进行CTC检测,部分患者进行CTEC检测,分析CTC及CTEC与鼻咽癌患者放疗及化疗之间的关系,并探究鼻咽癌CTC与CTEC之间的相关性。结果 共纳入191例鼻咽癌患者,其中初治治疗前66例,诱导化疗后38例,同步放化疗后87例;127例患者行CTEC检查,其中初治治疗前41例,诱导化疗后29例,同步放化疗后57例。各治疗阶段组患者CTC阳性率分别为89.4%、81.6%以及69.0%,其中仅初治治疗前组与同步放化疗后组差异有统计学意义(P=0.003);同步放化疗后组CTC数目分别较初治治疗前组、诱导化疗后组减少(P<0.001,P=0.002);同步放化疗后组三倍体CTC数目与初治治疗前组、诱导化疗后组差异有统计学意义(P=0.009,P=0.013);同步放化疗后组四倍体CTC数目与诱导化疗后组差异有统计学意义(P=0.007);同步放化疗后组多倍体(五倍体或8号染色体拷贝数>5)CTC数目与初治治疗前组差异有统计学意义(P<0.001)。各治疗阶段组患者CTEC阳性率分别为70.7%、82.8%以及64.9%,差异无统计学意义(P>0.05);同步放化疗后组CTEC数目仅较诱导化疗后组减少(P=0.009);各组间三倍体、四倍体CTEC数目差异无统计学意义(P=0.265,P=0.088);多倍体CTEC数目仅同步放化疗后组与诱导化疗后组之间差异有统计学意义(P=0.007)。Spearman相关性分析结果显示,CTC和CTEC之间呈正相关关系(rs=0.437,P<0.001)。结论 同步放化疗对鼻咽癌患者血液CTC数目的减少起着重要作用,而诱导化疗似乎并不会直接引起CTC数目的改变。鼻咽癌患者中,不同倍型CTC对不同治疗方式所产生的应答不同。鼻咽癌CTEC水平与Objective To investigate the relationships between circulating tumor cells(CTCs),circulating tumor endothelial cells(CTECs)and treatment methods in patients with nasopharyngeal carcinoma(NPC)at different stages of treatment.Methods The data of NPC patients at different treatment periods in West China Hospital of Sichuan University from March 2016 to November 2019 were retrospectively collected.The patients received CTCs test and part of those patients received CTECs test,by subtraction enrichment-immunostaining-fluorescence in situ hybridization.The relationships of CTCs and CTECs with radiotherapy and chemotherapy,and the correlations between CTCs and CTECs in NPC patients were analyzed.Results A total of 191 patients were included.Among them,there were 66 cases before initial treatment,38 cases after induction chemotherapy,and 87 cases after concurrent chemoradiotherapy.A total of 127 patients received CTECs test,including 41 cases before initial treatment,29 cases after induction chemotherapy,and 57 cases after concurrent chemoradiotherapy.The positive rates of CTCs were 89.4%,81.6%and 69.0%respectively in the three stages of treatment,and the difference was statistically significant only between the pre-treatment group and the post-concurrent chemoradiotherapy group(P=0.003).The number of CTCs in the post-concurrent chemoradiotherapy group was lower than that in the pre-treatment group and the post-induction chemotherapy group(P<0.001,P=0.002).The number of triploid CTCs in the post-concurrent chemoradiotherapy group was significantly different from that in the pre-treatment group and the post-induction chemotherapy group(P=0.009,P=0.013).The number of tetraploid CTCs in the post-concurrent chemoradiotherapy group was significantly different from that in the post-induction chemotherapy group(P=0.007).The number of polyploidy(pentaploid or>5 copies of chromosome 8)CTCs in the post-concurrent chemoradiotherapy group was significantly different from that in the pre-treatment group(P<0.001).The positive rates of

关 键 词：差相富集-瘤标免疫荧光染色-染色体原位杂交 循环肿瘤细胞 循环肿瘤内皮细胞 鼻咽癌 治疗方案 

分 类 号：R739.63[医药卫生—肿瘤]