外周血循环肿瘤细胞在卵巢癌化疗中的临床应用

Clinical application of peripheral blood circulating tumor cells with therapeutic effect of chemotherapy in ovarian cancer

目的探讨卵巢癌患者外周血中循环肿瘤细胞(CTC)变化情况与化疗疗效的关系。方法选择2013年2月至2015年4月间在我院接受化疗的卵巢癌患者28例,分别抽取其化疗前后外周静脉血4 ml,采用免疫磁珠微粒阴性富集技术和免疫荧光原位杂交技术(im FISH)检测CTC数目,以CTC≥2个/3.2 ml定义为阳性。采用RECIST 1.0版标准评价化疗疗效,观察化疗前后CTC变化与疗效的关系。结果化疗前外周血CTC阳性率为60.71%(17/28),其与肿瘤分期(P=0.019)及CA125水平(P=0.022)有关;化疗后CTC阳性率为25%(7/28)。根据化疗前后CTC的变化,将患者分为阳性-阳性、阳性-阴性、阴性-阳性、阴性-阴性4组,4组有效率分别为80.0%(4/5)、83.3%(10/12)、0(0/2)和88.9%(8/9),差异有统计学意义(P=0.045)。结论化疗前后CTC变化与疗效有一定关系,CTC可作为评估卵巢癌化疗疗效的参考指标。

Objective To investigate the relationship between the change of circulating tumor cells （ CTC） in peripheral blood and the chemotherapy effect of ovarian cancer. Methods A total of 28 ovarian cancer patients treated with chemotherapy in our department from February 2013 to April 2015 were enrolled in this study. Venous blood samples of 4 ml were collected from them before and after chemotherapy. The CTC in peripheral blood were purified by negative selection using immunomagnetic, and detected by im-mune fluorescence in situ hybridization （imFISH）. The CTC number over 2 in 3. 2 ml was defiend as positive. The RECIST 1. 0 criteria was used to assess the efficiency of chemotherapy, the relationship between the change of CTC before and after chemotherapy to the therapeutic effect of chemotherapy was studied. Results The positive rate of CTC before chemotherapy was 60. 71%（17/ 28）, which was related with tumor stage （P= 0. 017） and CA125 levels （P= 0. 049）, while it of CTC detected after chemotherapy was 25%（7/28）. According to the status of CTC before and after chemotherapy,the patients were divided into 4 groups,that is,positive to positive, positive to negative, negative to positive and negative to negative groups.Their efficiencies was 80%（4/ 5）,83. 33%（10/ 12）,0（0/ 2） and 88. 89%（8/ 9） respectively, with significant difference（P = 0. 045）. Conclusion The changes of CTC before and after chemo-therapy has a certain relationship with the efficiency to chemotherapy. CTC can be regarded as a predictor for evaluating chemotherapy.