结肠癌手术前后外周血游离癌细胞变化

Change of Circulation Cancer Cells in Perioperative and Postoperative Peripheral Blood of Patients with Colon Carcinoma

目的探讨免疫磁珠技术检测大肠癌患者术前、术后外周血游离癌细胞的变化情况。方法利用免疫磁珠技术富集2004年1月～2005年12月间,行根治术治疗的43位结肠癌患者术前、术后外周血肿瘤细胞,比较手术前后血中游离癌细胞的变化情况,并利用常规病理和免疫组化确认血中游离癌细胞。结果术前大肠癌组患者外周血测得的癌细胞阳性率为37.21%(16/27),术后血中游离癌细胞阳性检出率为60.47%(26/17),健康志愿者对照组为0,术前、术后和健康志愿者之间比较具有统计学意义(P<0.05)。术前、术后外周血癌细胞阳性与肿瘤部位、肿瘤病理分型无明显随关系。术前TNMⅠ期、TNMⅡa期、TNMⅡb期之间无统计学意义,与TNMⅢ期之间比较有统计学意义。术后TNMⅠ期与TNMⅡa期间无统计学意义,与TNMⅡb、TNMⅢ期之间比较,有统计学意义,但术后TNMⅡa期与TNMⅡb期间无统计学意义,与TNMⅢ期之间比较,有统计学意义;术后TNMⅡb期与TNMⅢ期间无统计学意义。结论免疫磁珠技术是一种有效检测患者外周血中游离肿瘤细胞的方法,可以从大肠癌患者外周血中分离富集肿瘤细胞,对大肠癌患者术后复发转移评估具有重要临床价值。手术牵拉可导致癌细胞进入外周血,是导致术后复发转移的因素之一。

Objective To explore the change of circulation cancer cells in perioperative and postoperative peripheral blood of patients with colon carcinoma by immunomagnetie beads （IMB） technique. Methods Circulation cancer cells in preoperative and postoperative peripheral blood of 43 patients with colon carcinoma be reseeted between January 2004 and December 2005 were separated respectively by immunomagnetie beads （IMB） technique. The change of preoperative and postoperative circulation cancer cells was compared with each other. Cells separated by IMB were identified by conventional pathology and immuoeytoehemistry. Result The positive rate of circulation cancer cells in peripheral blood of preoperative patients with colonic carcinoma was 37.21% （16/27）and in postoperative was 60.47% （26/17）. Circulation cancer cells in peripheral blood of healthy volunteers were negative. There was significant in positive rates of circulation cancer cells in peripheral blood between preoperative and postoperative and healthy volunteer （ P 〈 0.05） . There were no relations between positive of circulation cancer cells in preoperative and postoperative patients and the position and type of pathology of co- lonic carcinoma. Conclusion Immunomagnetie beads technique is an efficient technique to detect circulation colonic carcinoma cells in peripheral blood of patients with colonic carcinoma. It is very useful to evaluate the recrudescence and metastasis of colonic carcinoma after operation. Metastasis and recrudescence of patients with colonic carcinoma after operation were relational with positive of colonic carcinoma cells in peripheral blood.