循环肿瘤细胞对结直肠癌转移风险的预测与预后评估  

Predictive Value of Circulating tumor cells for Metastatic Risk and Prognostic Evaluation in Colorectal Cancer

作　　者：吴书妹 郭小燕 李波静[1] 石益海[1] WU Shumei;GUO Xiaoyan;LI Bojing;SHI Yihai(Department of Gastroenterology,Gongli Hospital,Pudong New District,Shanghai 200135,China)

机构地区：[1]上海市浦东新区公利医院消化内科,上海200135

出　　处：《延边大学医学学报》2025年第3期7-10,共4页Journal of Medical Science Yanbian University

基　　金：2025年度浦东新区卫生健康委员会研究者发起的临床研究项目(编号:2025-PWYC-04)。

摘　　要：目的:探讨循环肿瘤细胞(CTC)在结直肠癌(CRC)肝脏和淋巴结转移和预后中的预测价值。方法:分析2022年6月至2023年8月上海市浦东新区公利医院收治的300例CRC患者,依据转移部位的不同分为未转移组(n=157)、肝脏转移组(n=41)和淋巴结转移组(n=102)。用Pearson相关性分析CTC与患者临床特征的关系,用ROC曲线评估CTC对患者转移风险的预测价值,用Kaplan-Meier曲线分析CTC阳性与患者生存期的关系。结果:肝脏和淋巴结转移组在肿瘤类型、分化程度、原发部位、最大直径和CTC阳性率上与未转移组存在差异(P<0.05)。CTC数量与肝脏转移患者溃疡型、低分化、结肠原发及最大直径≥5 cm的肿瘤特征相关(P<0.05);与淋巴结转移患者溃疡型、低分化、直肠原发及最大直径≥5 cm的肿瘤特征相关(P<0.05)。ROC曲线显示,CTC阳性预测CRC肝脏和淋巴结转移的AUC为0.737和0.771。Kaplan-Meier曲线分析显示,CTC阳性患者无进展生存期和总生存期短于未转移患者(P<0.05)。结论:CTC对CRC肝脏和淋巴结转移具有较高的预测价值,CTC阳性与CRC转移患者预后相关。Objective:To investigate the predictive value of circulating tumor cells(CTCs)in liver and lymph node metastasis and prognosis of colorectal cancer(CRC).Methods:A total of 300 CRC patients admitted to Gongli Hospital,Pudong New District,Shanghai,from June 2022 to August 2023 were analyzed and categorized into non-metastatic(n=157),liver metastasis(n=41),and lymph node metastasis(n=102)groups based on metastatic sites.Pearson correlation analysis was used to evaluate the relationship between CTCs and clinical characteristics.ROC curves were employed to assess the predictive value of CTCs for metastatic risk,and Kaplan-Meier curves were utilized to analyze the association between CTC positivity and patient survival.Results:Significant differences in tumor type,differentiation degree,primary site,maximum tumor diameter,and CTC positivity rate were observed between the liver/lymph node metastasis groups and the non-metastatic group(P<0.05).CTC counts correlated with ulcerative type,poor differentiation,colonic origin,and maximum tumor diameter≥5 cm in liver metastasis patients(P<0.05),and with ulcerative type,poor differentiation,rectal origin,and maximum tumor diameter≥5 cm in lymph node metastasis patients(P<0.05).ROC analysis revealed AUC values of 0.737 and 0.771 for CTC positivity in predicting liver and lymph node metastasis,respectively.Kaplan-Meier analysis demonstrated that CTC-positive patients had shorter progression-free survival(PFS)and overall survival(OS)compared to non-metastatic patients(P<0.05).Conclusion:CTCs exhibit high predictive value for liver and lymph node metastasis in CRC,and CTC positivity is associated with poor prognosis in metastatic CRC patients.

关 键 词：结直肠癌 循环肿瘤细胞 转移 预后 

分 类 号：R735.3[医药卫生—肿瘤]