腹腔镜结直肠癌根治术后血清趋化因子配体5、循环肿瘤细胞CK20表达与肿瘤复发、转移的关系研究

The Relationship between CXCL5 and CK20 Expression of Circulating Tumor Cells and Recurrence and Metastasis after Laparoscopic Radical Resection of Colorectal Cancer

目的:探讨腹腔镜结直肠癌根治术后血清趋化因子配体5(CXCL5)、循环肿瘤细胞CK20的表达与肿瘤复发、转移的关系。方法:选取2015年5月—2017年7月在河北中石油中心医院接受腹腔镜结直肠癌根治手术治疗的120例结直肠癌患者,术后1 d检测两组血清CXCL5、外周血循环肿瘤细胞CK20的水平,并对患者进行为期36个月的随访观察,其中发生局部复发或转移的患者84例(复发组)、未发生局部复发或转移的患者36例(对照组);比较两组患者的一般资料、病理学资料及术后1 d的CXCL5、循环肿瘤细胞CK20表达情况;采用Logistic多因素分析CXCL5、循环肿瘤细胞CK20与肿瘤复发的关系。结果:复发组和对照组的年龄、性别、体质指数(BMI)、肿瘤位置差异无统计学意义(P>0.05);复发组与对照组的肿瘤直径、病理学类型、肿瘤分化程度、是否伴有肠梗阻、TNM分期、淋巴结转移、肿瘤淋巴血管侵犯比较差异有统计学意义(P<0.05);复发组的血清CXCL5水平、外周血循环肿瘤细胞CK20阳性检出率高于对照组,差异有统计学意义(P<0.05);Logistic多因素分析结果显示,肿瘤低分化、肠梗阻、TNM分期为Ⅲ~Ⅳ期、发生淋巴结转移、发生肿瘤淋巴血管侵犯、血清CXCL5水平增高、外周血循环肿瘤细胞CK20阳性表达是结直肠癌患者腹腔镜根治手术后复发、转移的独立危险因素(P<0.05)。结论:血清CXCL5水平增高、外周血循环肿瘤细胞CK20阳性表达可增大结直肠癌患者腹腔镜根治手术后复发、转移的风险。

Objective To explore the relationship between the expression of serum CXCL5 and circulating tumor cell CK20 after laparoscopic radical resection of colorectal cancer and tumor recurrence and metastasis.Methods A total of 120 colorectal cancer patients who underwent laparoscopic radical resection of colorectal cancer in our hospital were selected.Serum CXCL5 and CK20 levels of circulating tumor cells in the peripheral blood of the two groups were detected 1 day after operation.The patients were followed up for 36 months.84 patients with local recurrence or metastasis(recurrence group),36 patients without local recurrence or metastasis(control group).The general data,pathological data,CXCL5 and circulating tumor cell CK20 expression at 1 day postoperatively were compared between the two groups.Logistic multivariate analysis was used to analyze the relationship between CXCL5,circulating tumor cell CK20 and tumor recurrence.Results There was no significant difference in age,gender,BMI and tumor location between the recurrence group and the control group(P>0.05).Comparison of tumor diameter,pathological type,tumor differentiation,intestinal obstruction,TNM staging,lymph node metastasis,tumor lymphatic vascular invasion between the recurrence group and the control group were statistically significant(P<0.05).The level of serum CXCL5 and the positive detection rate of circulating tumor cells CK20 in the recurrence group were higher than those in the control group,which the difference was statistically significant(P<0.05).After multi-factor analysis,poorly differentiated tumors,intestinal obstruction,TNM staging(Ⅲ+Ⅳ),lymph node metastasis,tumor lymphatic vascular invasion,increased serum CXCL5 level and positive expression of CK20 in peripheral blood circulating tumor cells are the results of laparoscopic radical treatment of colorectal cancer patients independent risk factors for recurrence and metastasis after surgery(P<0.05).Conclusion Increased serum CXCL5 levels and positive expression of CK20 in peripheral blood circulating tumor cells can increase the risk of recurrence and metastasis after laparoscopic radical surgery for colorectal cancer patients.