上皮间质转化型循环肿瘤细胞表达对晚期非鳞非小细胞肺癌一线应用贝伐珠单抗联合化疗疗效和预后的预测价值  

Prediction value of epithelial-stromal transformed circulating tumor cell expression in first-line bevacizumab combined with chemotherapy for advanced non-squamous non-small cell lung cancer

作　　者：刘阳阳 LIU Yangyang(Department of Oncology,Xintai People's Hospital,Tai'an,Shandong,271200,China)

机构地区：[1]新泰市人民医院肿瘤科,山东泰安271200

出　　处：《当代医学》2024年第23期93-97,共5页Contemporary Medicine

摘　　要：目的分析上皮间质转化(epithelial-mesenchymal transition,EMT)型循环肿瘤细胞(circulating tumor cells,CTCs)表达对晚期非鳞非小细胞肺癌(non-small cell lung cancer,NSCLC)一线应用贝伐珠单抗联合化疗疗效和预后的预测价值。方法选取2019年2月至2020年1月于新泰市人民医院肿瘤科行一线接受贝伐珠单抗联合化疗治疗的49例晚期非鳞NSCLC患者作为研究对象,分别于治疗前后检测EMT型CTCs表达情况,分析典型EMT型CTCs荧光染色特点、晚期非鳞NSCLC患者临床病理特征与CTCs表达的关系,比较EMT型CTCs阳性与阴性患者、治疗后EMT型CTCs升高与降低患者近期疗效,绘制Kaplan-Meier生存曲线,采用Cox回归模型分析EMT型CTCs不同表达患者与预后[无进展生存期(progression free survival,PFS)、总生存期(overall survival,OS)]的关系。结果晚期非鳞NSCLC患者CTCs细胞形态细胞结构完整,细胞核染色致密,细胞直径>15μm,细胞核质比>0.8,无CD4、上皮细胞黏附分子(epithelial cell adhesion molecule,EpCAM)荧光信号。49例晚期非鳞NSCLC患者中,EMT型CTCs阳性表达30例,阳性率为61.22%。多脏器转移患者EMT型CTCs阳性率高于单发转移患者,差异有统计学意义(P<0.05);EMT型CTCs阳性与阴性患者疾病控制率(disease control rate,DCR)及中位PFS、OS比较差异均无统计学意义。治疗后,49例晚期非鳞NSCLC患者中,EMT型CTCs上升19例,下降29例;EMT型CTCs降低患者DCR为86.21%,高于EMT型CTCs升高患者的21.05%,差异有统计学意义(P<0.05);治疗后EMT型CTCs降低患者中位PFS、OS分别为9、15个月,均长于EMT型CTCs升高患者的5.1、10个月,差异有统计学意义(P<0.05)。结论治疗后EMT型CTCs变化对晚期非鳞NSCLC一线贝伐珠单抗联合化疗治疗的近期疗效、无进展生存及总生存具有预测价值。Objective To analyze the predictive value of epithelial-mesenchymal transition(EMT)type circulating tumor cells(CTCs)expression on the efficacy and prognosis of first-line application of bevacizumab combined with chemotherapy in advanced non-squamous non-small cell lung cancer(NSCLC).Methods A total of 49 patients with non-squamous advanced NSCLC who received first-line treatment with bevacizumab combined with chemotherapy in the Oncology department of Xintai People's Hospital from February 2019 to January 2020 were selected as the study subjects,the expression of EMT type CTCs was detected before and after treatment,respectively,the fluorescence staining characteristics of typical EMT-type CTCs,the relationship between clinicopathological features and CTCs expression in patients with advanced non-squamous NSCLC were analyzed,the short-term efficacy of patients with positive and negative EMT CTCs and patients with increased and decreased EMT CTCs after treatment were compared,Kaplan-Meier survival curve was drawn,and Cox regression model was used to analyze the relationship between patients with different expressions of EMT-type CTCs and prognosis(progression free survival[PFS]and overall survival[OS]).Results CTCs cell morphology and cell structure of patients with advanced non-squamous NSCLC were intact,dense cell staining,cell diameter>15μm,cytoplasmic ratio>0.8,and no CD4 and epithelial cell adhesion molecule(EpCAM)fluorescence signal.Among the 49 patients with advanced non-squamous NSCLC,30 cases were positive for EMT type CTCs,with a positivity rate of 61.22%.The positive rate of EMT type CTCs in patients with multiple organ metastasis was higher than that in patients with single metastasis,and the difference was statistically significant(P<0.05);there were no significant differences in disease control rate(DCR),median PFS and OS between positive and negative EMT CTCs patients.After treatment,among 49 patients with advanced non-squamous NSCLC,EMT CTCs increased in 19 cases and decreased in 29 cases;the DCR

关 键 词：上皮间质转化型循环肿瘤细胞 贝伐珠单抗 晚期非鳞非小细胞肺癌 

分 类 号：R73[医药卫生—肿瘤]