外周血循环肿瘤细胞计数诊断胰腺导管腺癌临床价值研究

Correlation between peripheral circulating tumor cells enumeration and clininical pathological characteristics of pancreatic ductal adenocarcinoma

目的研究外周血循环肿瘤细胞（CTCs）检测在胰腺导管腺癌病人中是否可行,并通过与相关临床病理学信息的比较,验证其临床应用价值。方法连续性选取复旦大学附属中山医院2014年10月至2015年6月期间经影像学诊断并术后病理学检查证实的22例胰腺导管腺癌病人作为研究对象,其中男性14例,女性8例。年龄平均（63.91±9.31）岁。采集病人外周静脉血各7.5 m L,通过CellSearch系统进行肿瘤细胞检测,并比较肿瘤细胞计数与病人病理信息的关系。结果所有病人获根治性切除,术前未行化疗。CTCs阳性15例（15/22,68.18%）,总体细胞计数范围0-13个/7.5 m L外周血;淋巴结转移病人的阳性率显著高于无转移病人（P=0.034）;肿瘤最大径在2 cm以上同时伴有术前CA19-9升高的病人,CTCs阳性率显著升高（P=0.014）。结论 CTCs计数在胰腺导管腺癌诊治中具有可行性,且与病人的临床病理学特征有良好的对应关系。

Objective To study whether the theory of circulating tumor cells is practical and observe its clinical value according to the comparison with pathological data.Methods A total of 22 patients who was suspected with pancreatic ductal adenocarcinoma was recruited consecutively from October 2014 to June 2015 in Zhongshan Hospital of Fudan University.The peripheral blood sample was obtained post-resection.Among them,there were 14 males and 8 females and the mean age was（63.91 ±9.31） years old.Each patients was drawn 7.5mL of blood from peripheral vein.The platform of CellSearch was used to capture the tumor cells.The correlations between the tumor cell enumeration and the pathological data were analyzed.Results All the patients were perfomred radical resection.No chemotherapy was performed before surgery.Overall,EpCAM（＋）-CTCs were captured in 15 patients（15/22,68.18%）,and the enumeration range was 0—13/7.5mL peripheral blood.Compared with the control group,patients with lymph metastases,tumor size larger than 2 cm accompanied with CA19-9 elevated preoperatively were likely to have higher capture rate of tumor cells（P=0.014）.Conclusion Peripheral circulating tumor cells enumeration is practical in pancreatic ductal adenocarcinoma,which plays certain role in predicting the prognosis of those patients.