循环肿瘤细胞与局部晚期直肠癌新辅助治疗疗效关系的研究  

Study on the relationship between circulating tumor cells and the efficacy of neoadjuvant therapy for locally advanced rectal cancer

作　　者：汪林军 Wang Linjun(First Affiliated Hospital of Qiannan Ethnic Medicine College,People's Hospital of Qiannan Buyi and Miao Autonomous Prefecture,Duyun,Guizhou 558000,China)

机构地区：[1]黔南民族医学高等专科学校第一附属医院,黔南布依族苗族自治州人民医院,贵州都匀558000

出　　处：《首都食品与医药》2025年第5期48-51,共4页Capital Food Medicine

基　　金：2022年贵州省卫健委项目(编号:gzwkj2023-285);2022年黔南医专科研项目目(编号:Qnyz202230)。

摘　　要：目的 探讨循环肿瘤细胞(Circulating Tumor Cells,CTCs)与局部晚期直肠癌(Locally Advanced Rectal Cancer,LARC)新辅助治疗的疗效关系.方法 在本院2022年8月-2024年7月期间接受新辅助治疗的LARC患者中,采用便利抽样法纳入56例进行研究,所有患者均预计接受手术治疗.分别在新辅助治疗前及术前采集患者静脉血检测CTCs计数,以CTCs计数>3个CTCs/7.5mL为阳性诊断标准.对比新辅助治疗前CTCs检查阳性及阴性患者的各项基线指标,统计新辅助治疗的临床疗效、不同临床疗效下新辅助治疗前后的CTCs计数及不同CTCs分型患者新辅助治疗的临床疗效.结果 在纳入的56例LARC患者中均检出CTCs,其中阳性率为73.21%.CTCs检验阳性及阴性患者的性别、肿瘤病灶下缘与肛门间距、T分期相比,差异无统计学意义(P>0.05);CTCs检验阳性患者临床分期ⅢB、C期及N分期N+检出率高于CTCs检验阴性患者(P<0.05).在56例LARC患者中检出E-CTCs型56例、E/M-CTCs型41例、M-CTCs型46例、CTM型38例,不同临床分期LARC患者各类型CTCs检出率相比,无统计学差异(P>0.05);不同N分期LARC患者E-CTCs、E/M-CTCs检出率相比、无统计学差异(P>0.05);N+患者M-CTCs、CTM检出率高于NO患者(P<0.05).新辅助治疗后,疗效为CR患者9例、PR23例、NR24例,所有患者CTCs计数均显著低于新辅助治疗前,且治疗前后临床疗效为NR患者CTCs计数均最高、CR患者最低,组间相比,存在统计学差异(P<0.05).结论 CTCs与LARC之间存在密切关系,不同分型CTCs患者病灶转移风险存在区别,可为临床治疗提供支持,同时CTCs计数越高,患者预后效果越差,可作为评估新辅助治疗LARC患者预后的重要指标.Objective To investigate the relationship between circulating tumor cells(CTCs)and neoadjuvant therapy for locally advanced rectal cancer(LARC).Methods Among LARC patients who received neoadjuvant therapy from August 2022 to July 2024,56 cases were included in the study using convenience sampling method,and all patients were expected to receive surgical treatment.Collect venous blood samples from patients before neoadjuvant therapy and before surgery to detect CTCs count,with a positive diagnostic criterion of CTCs count>3 CTCs/7.5mL.Compare baseline indicators of patients with positive and negative CTCs before neoadjuvant therapy,calculate the clinical efficacy of neoadjuvant therapy,count CTCs before and after neoadjuvant therapy under different clinical efficacy,and evaluate the clinical efficacy of neoadjuvant therapy in patients with different CTCs subtypes.Results CTCs were detected in all 56 LARC patients included,with a positive rate of 73.21%.There was no statistically significant difference(P>0.05)in gender,distance between tumor lesions and anus,and T staging between patients with positive and negative CTCs test;the detection rate of N+in clinical stage III B,C and N in patients with positive CTCs test is higher than that in patients with negative CTCs test(P<0.05).Among 56 LARC patients,E-CTCs were detected in 56 cases,E/M-CTCs in 41 cases,M-CTCs in 46 cases,and CTM in 38 cases.There was no statistically significant difference in the detection rates of various types of CTCs among LARC patients in different clinical stages(P>0.05);there was no statistically significant difference in the detection rates of E-CTCs and E/M-CTCs among patients with different N-stage LARC(P>0.05);the detection rates of M-CTCs and CTM in N+patients were higher than those in N0 patients(P<0.05).After neoadjuvant therapy,the therapeutic effects were 9 cases of CR patients,23 cases of PR,and 24 cases of NR.The CTCs counts of all patients were significantly lower than before neoadjuvant therapy,and the clinical efficacy before a

关 键 词：循环肿瘤细胞 局部晚期直肠癌 新辅助治疗 

分 类 号：R735.37[医药卫生—肿瘤]