循环肿瘤细胞检测对结直肠癌术后患者预后的价值

Prognostic Value of Circulating Tumor Cell Detection in Postoperative Colorectal Cancer Patients

目的:评估循环肿瘤细胞(CTC)检测对结直肠癌术后患者预后的价值。方法:收集粤北人民医院2018年11月至2020年6月间收治的99例Ⅱ~Ⅲ期结直肠癌患者作为研究对象,患者均行结直肠癌根治性切除手术,术后1~2周在进行任何术后辅助治疗前采集7.5 mL外周血行CTC检测,术后6个月再进行1次CTC检测。根据两次CTC检测结果分为L组36例(两次CTC<3个)、H组34例(两次CTC≥3个)和LH组29例(术后CTC<3个,6个月后CTC≥3个)。术后根据美国国立综合癌症网络(NCCN)指南进行相关辅助治疗及随访,比较三组患者的临床资料和预后。结果:L组的复发转移率及死亡率低于H组和LH组,H组和LH组患者的复发转移率及死亡率差异均无统计学意义(P>0.05)。L组的中位无进展生存时间(PFS)为32个月,H组为22个月,LH组为24个月,差异具有统计学意义(P<0.001)。L组中位总生存时间(OS)为32个月,H组为28个月,LH组为26个月,差异具有统计学意义(P=0.018)。但H组与LH组患者的PFS及OS的差异均无统计学意义(P>0.05)。结论:CTC检测可以作为评估结直肠癌术后患者预后的一个因子,术后CTC正常的患者PFS及OS高于术后CTC升高的患者。

Objective To evaluate the prognostic value of circulating tumor cell(CTC)detection in postoperative patients with colorectal cancer.Methods A total of 99 patients with stageⅡ-Ⅲcolorectal cancer who were admitted to Yuebei People’s Hospital from November 2018 to June 2020 were collected as the research objects.All patients underwent radical resection of colorectal cancer.7.5 mL peripheral blood was collected for CTC detection 1 to 2 weeks after surgery before any postoperative adjuvant therapy,and another CTC detection was performed 6 months after surgery.According to the two CTC detection results,the patients were divided into group L(CTC<3)(36 cases),group H(CTC≥3)(34 cases)and group LH(CTC<3 after surgery,CTC≥3 after 6 months)(29 cases).Postoperative adjuvant therapy and follow-up were performed according to the National Comprehensive Cancer Network(NCCN)guidelines.The clinical data and prognosis of the three groups were compared.Results The recurrence,metastasis rate and mortality rate in the group L were lower than those in the group H and group LH,and there was no significant difference between the group H and group LH(P>0.05).The median progression-free survival(PFS)was 32 months in the group L,22 months in H group,and 24 months in the group LH,and the differences were statistically significant(P<0.001).The median overall survival(OS)was 32 months in L group,28 months in the group H,and 26 months in the group LH,and the differences were statistically significant(P=0.018).However,there was no significant difference in PFS and OS between the group H and the group LH(P>0.05).Conclusion CTC detection can be used as a prognostic factor in patients with colorectal cancer after surgery.Patients with normal CTC after surgery have higher PFS and OS than those with elevated CTC after surgery.