CellSearch和CTC-Biopsy系统检测肾细胞癌患者外周血CTCs价值探讨

Value of CellSearch and CTC-Biopsy system in detecting peripheral blood CTCs in patients with renal cell carcinoma

目的探讨CellSearch和CTC-Biopsy系统检测肾细胞癌(又称肾癌)患者外周血循环肿瘤细胞(CTCs)的价值及临床意义。方法应用CellSearch和CTC-Biopsy系统同时检测山东省肿瘤医院收治的37例肾癌患者外周血CTCs,分析CTCs检测结果与患者临床病理特征和预后之间的关联性。2种检测方法结果比较采用χ^(2)检验及一致性检验。采用Kaplan-Meier法绘制生存曲线,Log-rank检验对生存数据进行分析,Cox比例风险回归模型分析评估影响预后的因素。结果CellSearch系统在7例患者中检测到外周血CTCs,总检出率为18.92%(7/37),无循环肿瘤细胞团(CTM)检出;CTC-Biopsy系统在13例患者外周血中检测到CTCs/CTM,CTCs/CTM总检出率为35.14%(13/37)。CellSearch检测结果与肾癌患者的各项病理因素均无关联性(均P>0.05);CTC-Biopsy检测结果与患者的TNM分期(χ^(2)=8.877,P=0.005)、肿瘤大小(χ^(2)=7.758,P=0.019)和肾癌危险度(χ^(2)=5.106,P=0.042)评分有关联。2种检测方法CTCs检测结果与肾癌患者5年无进展生存期(PFS)和总生存期(OS)无相关性(均P>0.05)。结论在肾癌患者中,CTC-Biopsy系统CTCs检出率高于CellSearch系统;CTC-Biopsy系统CTCs检测结果可以作为肾癌临床病理分期的有益补充。

Objective To investigate the value and clinical significance of CellSearch and CTC-Biopsy systems in detecting peripheral blood circulating tumor cells(CTCs)in patients with renal cell carcinoma.Methods CellSearch and CTC-Biopsy systems were used to simultaneously detect CTCs in peripheral blood of 37 patients with renal cell carcinoma admitted to Shandong Cancer Hospital,and analyzed the correlation between the detection results of CTCs and the clinicopathological characteristics and prognosis of patients.The results of the two detection methods were compared usingχ^(2)test and consistency test.Survival curves were drawn by the Kaplan-Meier method,and the log-rank test was used to analyze the survival data.Cox proportional hazards regression model was used to analyze the prognostic factors.Results Totally 7 patients were detected peripheral blood CTCs by CellSearch system,with a total detection rate of 18.92%(7/37),and no circulating tumor cell mass(CTM)was detected.Thirteen patients were detected peripheral blood CTCs/CTM by CTC-Biopsy system,and the total detection rate of that was 35.14%(13/37).There was no correlation between CellSearch test results and various pathological factors of renal cancer patients(all P>0.05).The CTC-Biopsy test results were associated with patients’TNM staging(χ^(2)=8.877,P=0.005),tumor size(χ^(2)=7.758,P=0.019)and renal cancer risk(χ^(2)=5.106,P=0.042)classification score was associated.There was no correlation between the CTCs detection results of the two detection methods and the 5-year progression-free survival(PFS)and overall survival(OS)of renal cancer patients(both P>0.05).Conclusions In patients with renal cell carcinoma,the detection rate of CTCs by the CTC-Biopsy system is higher than that of the CellSearch system.The detection results of CTCs by the CTC-Biopsy system can be a useful supplement for the clinicopathological staging of renal cancer.