肝细胞癌循环肿瘤细胞与肿瘤转移和预后关系的研究

Study on the relationship of circulating tumor cells and metastasis and prognosis of hepatocellular carcinoma

目的研究肝细胞癌(hepatocellular carcinoma,HCC)患者外周血循环肿瘤细胞(circulating tumor cell,CTC)与肿瘤转移和预后的关系。方法选取35例肝细胞癌患者,应用密度梯度离心法联合免疫磁珠阴性富集法富集CTC,然后利用染色体荧光原位杂交和细胞免疫荧光技术进行CTC鉴定并计数,同时记录临床相关特征,对数据进行统计学分析。结果所有患者均检出CTC,阳性率为100%,CTC个数均值为(4.1±2.5)个。对患者进行分组,Ⅰ组的CTC个数<5,Ⅱ组的CTC数量≥5。Ⅰ组、Ⅱ组的CTC数量差异有统计学意义(P=0.001),患者的性别、年龄与肿瘤转移无关(P=0.581、0.531),CTC的数量与转移及预后有关(P=0.024、0.01),Ⅰ组、Ⅱ组的转移和预后差异有统计学意义。结论 HCC患者外周血CTC的数量与肿瘤转移及预后有关,CTC的数量≥5时,可能肿瘤更具转移倾向,预后更差,患者生存期更短。

Objective To study the relationship between circulating tumor cells（CTCs） in peripheral blood of the pa‐tients with hepatocellular carcinoma （HCC） and its metastasis and prognosis .Methods 35 patients with hepatocellular carci‐noma were collected as the research objects .CTCs density were enriched through gradient centrifugation and negative‐immu‐nomagnetic methods ,then the cells were detected by chromosome fluorescence in situ hybridization combined with immunofluo‐rescence tests to identify CTCs .The clinical characters were recorded and the data were statistically analyzed .Results All the patients were detected CTC positive .The number of CTC was （4 .1 ± 2 .5） .The patients were divided into 2 groups .Group Ⅰincluded patients whose CTCs were ＆lt;5 ,and others were included in group Ⅱ .The difference between number of group I and group Ⅱ had significant significance（P=0 .001）;Metastasis had nothing to do with patients′sex and age（P=0 .581 ,0 .531）;The number of CTCs was related to metastasis and prognosis（P=0.024 ,0.01） ,and there was significant statistic significance between group I and groupⅡ .Conclusion The number of CTCs was related to tumor metastasis .The tumor may be more prone to occur metas‐tasis and may had worse prognosis ,and the patients may had shorter life time when the number of CTCs was≥5 .