CTCs联合血清肿瘤标记物检测在胃肠道恶性肿瘤术后早期复发的应用价值

Application value of CTCs combined with serum tumor markers in prediction early postoperative recurrence for patients with gastrointestinal tumor

目的:探讨循环肿瘤细胞(CTCs)联合血清肿瘤标记物检测在胃肠道恶性肿瘤术后早期复发的应用价值。方法:选择手术治疗的胃肠道恶性肿瘤患者43例,分别检测并比较患者手术治疗前后血清肿瘤标记物及CTCs的含量水平和阳性检出率,所有患者经手术治疗后均随访2年,比较术后复发/转移患者与未复发/转移患者血清中肿瘤标记物及CTCs检出阳性率。结果:中晚期胃肠道肿瘤患者血清中癌胚抗原(CEA)、糖蛋白抗原199(CA199)及CTCs的含量水平、检出阳性率著高于早期患者(P<0.05),患者经手术治疗后肿瘤标记物的含量水平及CTCs的检出阳性率显著降低(P<0.05);所有患者随访两年期间有18例患者发生复发或转移,术后复发/转移患者血清中CEA、CA199及CTCs检出阳性率显著高于未复发/转移患者(P<0.05);CTCs评估胃肠道肿瘤患者术后复发/转移的敏感性、特异性、阳性预测值以及阴性预测值高于肿瘤标记物单独的评估效能,CTCs联合血清肿瘤标记物的敏感性、特异性、阳性预测值、阴性预测值高于肿瘤标记物的联合评估效能。结论:CTCs联合血清肿瘤标记物预测胃肠道肿瘤患者术后复发或转移的评估效能显著优于血清肿瘤标记物的检验效能,为临床发现胃肠道肿瘤术后早期复发或转移提供线索。

Objective：To explore the application value of circulating tumor cells （CTCs） combined with serum tumor markers in prediction early postoperative recurrence for patients with gastrointestinal tumor.Methods： 43 patients with gastrointestinal cancer were enrolled, the serum tumor markers and CTCs levels and positive detection rate of which patients were detected and analyzed before and after treatment.Of all patients were followed up in 2 years after treatment, and which positive detection rate of serum tumor markers and CTCs were compared between postoperative recurrence / metastasis patients and non-recurrence / metastasis patients.Results： The CEA and CA199 level and the CTCs positive detection rate of patients with advanced gastrointestinal tumor were higher significantly than those patients with early gastrointestinal cancer （P＆lt;0.05）, after treatment, the serum tumor markers and CTCs detective positive rate decreased significantly compared with before treatment （P＆lt;0.05）;In the 2 years follow-up period, the positive detection rate of CEA, CA199 and CTCs of 18 postoperative recurrence / metastasis patients were higher significantly than those patients with non-recurrence / metastasis （P＆lt;0.05）;The sensitivity, specificity, positive predictive value and negative predictive value of CTCs for evaluation early postoperative recurrence for patients with gastrointestinal tumor were higher remarkably than those serum tumor markers, and the sensitivity, specificity, positive predictive value and negative predictive value of CTCs combined with serum tumor markers for predication was higher joint of tumor markers.Conclusion： The evaluation efficiency of CTCs combined with serum tumor markers for prediction the early postoperative recurrence in patients with gastrointestinal tumor was more accurate than those serum tumor markers, and which could provide valuable clues for clinical diagnosis the recurrence or metastasis of gastrointestinal cancer.