甲状腺乳头状癌患者术后外周血循环肿瘤细胞检测及临床意义

Significance of postoperatively detecting peripheral blood circulating tumor cells in patients with papillary thyroid cancer

目的探讨甲状腺乳头状癌(PTC)患者术后外周血循环肿瘤细胞(CTCs)的检测意义。方法选取我院143例PTC患者,使用ISET分离技术分离外周血CTCs并进行计数,所采用的仪器为武汉友芝友医疗科技股份有限公司开发的CTCBIOPSY D-100型分离仪。应用统计学方法分析外周血CTCs检测结果与PTC患者术后临床病理特征关系。结果143例受试患者中外周血CTCs阳性者占58.74%,年龄、性别、肿瘤数量和肿瘤大小与术后外周血CTCs阳性无明显相关(P>0.05);肿瘤TNM分期、术中瘤体侵犯肌肉和(或)喉返神经、术后常规病理淋巴结转移与术后外周血CTCs阳性明显相关(P<0.01)。Logistic回归分析显示:TNM分期、瘤体侵犯肌肉与(或)神经、淋巴结转移等代表PTC不良预后的因素是CTCs检测结果的独立影响因子[比值比(OR):2.417、3.168、3.101,P<0.05]。结论外周血CTCs阳性提示甲状腺乳头状癌预后不良。

Objective To investigate the significance of postoperatively detecting peripheral blood circulating tumor cells (CTCs) in the patients with papillary thyroid cancer (PTC). Methods A total of 143 patients diagnosed as having PTC in our department, receiving radical thyroidectomy were analyzed. The CTCBIOPSY D-100 equipment developed by You Zhiyou Medical Technology Co., Ltd. as well as ISET separation technique, were used to count the number of peripheral blood CTCs, and its relationship with the clinical features and prognosis of the patients were analyzed by the statistical method. Results The positive rate of CTCs in all 143 patients with PTC was 58.74%. Statistical analysis showed that the positive rate of peripheral blood CTCs in PTC patients was significantly correlated with TNM stage, tumor’s invasion of muscle and/or recurrent laryngeal nerve, and pathological lymphatic metastasis (P<0.01), but not with age, gender, tumor number and tumor size (P>0.05). Logistic regression statistical analysis indicated that the factors indicating poor prognosis of PTC such as TNM stage, tumor’s invasion of muscle and/or recurrent laryngeal nerve, lymphatic metastasis were independent influencing factors of CTCs [odds ratio (OR): 2.417, 3.168, 3.101, P<0.05]. Conclusion Positive CTCs in the peripheral blood postoperation may indicate a poor prognosis in patients with PTC.