非小细胞肺癌患者进行手术前后其循环肿瘤细胞测量值的变化与其肿瘤复发转移的相关性

Correlation of changes in measured values of circulating tumor cells in patients with NSCLC before and after surgery and their correlation with tumor recurrence and metastasis

目的 :探讨对非小细胞肺癌(NSCLC)患者进行手术前后其循环肿瘤细胞(CTC)测量值的变化与其肿瘤复发转移的相关性。方法 :将2015年1月至2016年1月期间在四川省人民医院进行外科手术的100例NSCLC患者作为研究对象。在进行手术前和进行手术后的48 h,对这100例患者均进行CTC检测。按照术后48 h患者的CTC测量值,将这100例患者分为CTC测量值高组(其CTC值≥1,n=60)和CTC测量值低组(其CTC值=0,n=40)。术后对这100例患者均进行为期2年的随访,观察其肿瘤复发转移的情况。对这100例患者进行手术前后其CTC的检测结果、肿瘤复发转移的情况和临床资料进行分析研究,从中找出NSCLC患者进行手术前后其CTC测量值的变化与其肿瘤复发转移的相关性。结果 :进行手术前患者的CTC测量值高于进行手术后48 h其CTC的测量值,差异有统计学意义(P<0.01)。对这100例患者进行随访的结果是:CTC测量值高组患者肿瘤复发转移的发生率高于CTC测量值低组患者,差异有统计学意义(P<0.05)。在发生肿瘤复发转移的患者中,进行全肺切除术的患者所占的比率、术后CTC测量值高的患者所占的比率、TNM分期为Ⅲ~Ⅳ期的患者所占的比率和低分化肿瘤患者所占的比率均高于未发生肿瘤复发转移的患者,差异有统计学意义(P<0.05)。进行手术后患者的CTC测量值高、TNM分期为Ⅲ~Ⅳ期和肿瘤低分化均是导致NSCLC患者发生肿瘤复发转移的独立危险因素。NSCLC患者进行手术后CTC的测量值、肿瘤的TNM分期与其发生肿瘤复发转移呈正相关。NSCLC患者肿瘤的分化程度与其发生肿瘤复发转移呈负相关。结论 :NSCLC患者在进行手术前后其CTC测量值会发生明显变化。CTC测量值与NSCLC患者发生肿瘤复发转移呈正相关。因此,可将CTC测量值作为评估NSCLC患者预后的重要参考指标。

Objective To investigate correlation of changes in measured values（CTC） of circulating tumor cells in patients with NSCLC before and after surgery and their correlation with tumor recurrence and metastasis. Methods Select the clinical data of 100 patients with NSCLC treated by surgery in our hospital during the period from February 2014 to 2015 for research. The quantity of CTC in blood of patients was detected before surgery and at 48 h after surgery. According the CTC value at 48 h after surgery, we divided the cases in high CTC group（CTC value ≥ 1,n=60）and low CTC group（CTC value=0,n=40）.We do 2 years of postoperative follow up for the 100 cases of patients, to observe situation of tumor recurrence and metastasis. Analyses CTC value, situation of tumor recurrence and metastasis and clinical material of the 100 cases, find the correlation of CTC value and tumor recurrence and metastasis of the NSCLC patients before and after surgery. Results The measured value of CTC in peripheral blood of 100 patients at 48 h after surgery was significantly lower than that before surgery（P 〈0.01）. The rate of recurrence and metastasis in patients with high measured value of CTC during 2 years of follow-up after surgery was significantly higher than that in patients with low measured value of CTC. The results of univariate analysis showed that TNM stage III-IV, low differentiation and high measured value of CTC after surgery were independent risk factors for recurrence and metastasis in patients with NSCLC after surgery（P 〈0.05）. The measured value of CTC in peripheral blood after surgery and tumor stage were obviously positively correlated with tumor recurrence and metastasis in patients with NSCLC after surgery（P 〈0.05）.The differentiated degree of tumor was obviously negatively correlated with tumor recurrence and metastasis in patients with NSCLC after surgery（P〈 0.05）.Conclusion There are obvious changes in measured values of CTC in patients with NSCLC before and after surgery. The measured value of CTC in peripheral can be an important reference indicator to evaluate prognosis in patients with NSCLC.