循环肿瘤细胞评估转移性结直肠癌微波消融治疗的初步研究

Monitoring of circulating tumor cells in patients with metastatic colorectal cancer undergoing microwave ablation

目的:利用循环肿瘤细胞(circulating tumor cells,CTCs)评估转移性结直肠癌微波消融治疗及其预后的相关性。方法:研究分析了2015年1月至2018年4月在东南大学附属第二医院因转移性结直肠癌行肺部或肝脏病灶微波消融治疗的34例患者的临床资料。术前及术后均进行CTCs检测,并搜集患者临床特征。应用统计方法进一步分析研究。结果:微波消融术后,患者的CTCs测量值较术前升高,差异具有统计学意义(P=0.003)。对性别、年龄、微波治疗部位(同转移部位)、微波术前后CTCs变化状况、微波术后CTCs数目与随访截止时期患者生存状态进行分析后得出:女性患者在随访截止时期的生存状态优于男性,差异具有统计学意义(P=0.011);微波术后CTCs数目<7个/ml的患者生存状态优于术后CTCs数目≥7个/ml者,差异具有统计学意义(P=0.030)。而年龄(P=0.274)、微波治疗部位(同转移部位)(P=0.271)、微波术前后CTCs变化状况(P=0.214)与随访截止时期患者的生存状态之间无统计学差异。结论:转移性结直肠癌的患者CTCs数目在微波消融术后会增加;女性患者在随访截止时期的生存状态优于男性;微波术后CTCs数目<7个/ml的患者生存状态优于术后CTCs数目≥7个/ml者;年龄、微波治疗部位(同转移部位)、微波术前后CTCs变化状况与随访截止时期患者疾病状态不相关。

Objective:To investigate the clinical value of circulating tumor cells (CTCs) in evaluating the prognostic value in patients with metastatic colorectal cancer undergoing microwave ablation. Methods:Total of 34 patients who received microwave ablation for hepatic or pulmonary metastases from colorectal cancer at the Second Hospital Attached to Southeast University from January 2015 to April 2018 were enrolled in this study.Preoperative blood samples from these patients were tested for CTCs.CTCs values and clinical materials of the 34 cases were analysed. Results:An increase in CTCs values after microwave ablation was found ( P =0.003).There were significant differences in prognosis between CTCs values ≥7/ml and <7/ml after microwave ablation ( P =0.030) and in gender ( P =0.011).However,age,site of microwave ablation and the change of CTC values after microwave ablation were no statistically significant ( P >0.05). Conclusion:The microwave ablation can cause the increase of CTCs values in the peripheral blood.There were significant differences in prognosis between CTCs values ≥7/ml and <7/ml after microwave ablation and in gender.