循环肿瘤细胞在结直肠癌患者外周血中的表达及其临床意义

Expression of circulating tumor cells in peripheral blood of patients with colorectal cancer and clinical significance

目的探讨结直肠癌患者外周血循环肿瘤细胞(CTC)的表达及其临床意义。方法应用CanPatrolTM CTCs检测技术检测2016年1月至2017年12月广东医科大学附属医院246例结直肠癌患者和35例健康查体者外周血中CTC的分布情况,探讨外周血CTC阳性率与结直肠癌患者临床病理参数之间的关系,以及CTC检测结果与结直肠癌患者生存差异的关系,并结合临床资料采用χ^(2)检验。结果以CTC数量≥2个/7.5 ml为CTC阳性作为分界,246例结直肠癌患者CTC阳性率为71.95%(177/246),明显高于35例健康受试者CTC阳性率5.71%(2/35),两者差异有统计学意义(χ^(2)=58.138,P<0.01)。CTC阳性率与结直肠癌患者TNM分期(TNM stage)、淋巴结转移明显相关(χ^(2)=7.199、4.200,P<0.05)。CTC≥2组177例中有136例在随访终点时间存活,存活率为76.84%(136/177),CTC<2组69例中有67例在随访终点时间存活,存活率为97.10%(67/69),两者差异有统计学意义(χ^(2)=14.135,P<0.01)。结论CTC与结直肠癌患者是否发生转移、TNM分期明显相关,CTC检测有助于结直肠癌辅助诊断、疗效监测和预后评估。

Objective To analyze the expression of circulating tumor cells(CTCs)in patients with colorectal cancer and their clinical significance.Methods The distribution of CTCs in the peripheral blood of 246 patients with colorectal cancer and 35 healthy subjects in Affiliated Hospital of Guangdong Medical University from January 2016 to December 2017 was detected by CanpatrolTM CTCS detection technique,the relationship between the positive rate of CTCs in peripheral blood and clinicopathological parameters of patients with colorectal cancer,as well as the relationship between the results of CTCs and the survival difference of patients with colorectal cancer was analyzed.The statistical analysis was done by Chi-square test combined with clinical data.Results The number of CTCs≥2/7.5 ml indicated the positive CTCs as the demarcation.The positive rate of CTCs in 246 patients with colorectal cancer was 71.95%(177/246),which was significantly higher than 5.71%(2/35)in 35 healthy subjects with significant difference(χ^(2)=58.138,P<0.01).The positive rate of CTCs was significantly correlated with tumor node metastasis stage(TNM stage)and lymph node metastasis in colorectal cancer patients(respectively,χ^(2)=7.199,4.200,P<0.05).Among the 177 patients in the CTCs≥2 group,136 survived at the end of the follow-up with the survival rate of 76.84%(136/177).In the CTCs<2 group,67 out of 69 patients survived at the end of the follow-up with the survival rate of 97.10%(67/69),and the difference between the two groups was statistically significant(χ^(2)=14.135,P<0.01).Conclusion There is a certain correlation between CTCs and the occurrence of metastasis and TNM stage in patients with colorectal cancer.CTCs detection is helpful for auxiliary diagnosis,efficacy monitoring and prognosis evaluation of colorectal cancer.