结直肠癌中循环肿瘤细胞的表达及与Ki-67的关系研究

Study on the expression of circulating tumor cell in colorectal cancer and its relationship with Ki 67

目的探讨结直肠癌中循环肿瘤细胞(CTC)及其分型的表达,并分析其与Ki-67表达的关系。方法选取230例结直肠癌患者,收集临床资料,利用CanPatrolTM二代检测技术检测CTC及其分型[上皮型CTC(eCTC)、混合型CTC(b CTC)和间质型CTC(m CTC)]的表达情况;采用免疫组化法检测结直肠癌患者结直肠癌组织中Ki-67的表达情况,分析结直肠癌患者CTC及其分型的表达与Ki-67表达的关系。结果 230例结直肠癌患者中,CTC阳性率为69.13%(159/230),Ⅰ、Ⅱ、Ⅲ期结直肠癌患者CTC阳性率分别为55.56%、64.58%、76.64%,mCTC阳性表达率分别为51.85%、66.71%、79.44%,CTC、mCTC阳性表达率随临床分期的升高而逐渐升高。不同分化程度、淋巴结转移情况、TNM分期结直肠癌患者CTC阳性表达率、mCTC阳性表达率及Ki-67表达情况比较,差异均有统计学意义(P﹤0.05)。Ki-67≥60%结直肠癌患者mCTC阳性表达率为73.85%,高于Ki-67﹤60%患者的57.14%(P﹤0.05)。结论随着结直肠癌的进展,CTC、mCTC阳性表达率逐渐升高,且mCTC可能参与结直肠癌血行转移过程;Ki-67表达水平与mCTC的阳性表达可能有关,二者对结直肠癌的发展、转移及预后评估有重要意义。

Objective To explore the expression of circulating tumor cell(CTC)and its type in colorectal cancer,and analyze its relationship with Ki-67 expression.Method A total of 230 patients with colorectal cancer were selected,and their clinical features were collected.The CanPatrolTMsecond-generation detection technology was used to measure the expression of CTC and their phenotypes[epithelial CTC(eCTC),biophenotypic CTC(bCTC),and mesenchymal CTC(mCTC)].Immunohistochemical method was used to detect the expression of Ki-67 in colorectal cancer tissue of patients with colorectal cancer,and analyze the relationship between the expression of CTC and its type and the expression of Ki-67 in patients with colorectal cancer.Result Among 230 patients with colorectal cancer,the positive rate of CTC was69.13%(159/230).The positive rate of CTC in patients with stageⅠ,Ⅱ,andⅢcolorectal cancer were 55.56%,64.58%,and 76.64%,respectively,and the positive expression rates of m CTC were 51.85%,66.71%,79.44%,the positive expression rate of CTC and mCTC gradually increased with the increase of clinical stage.There were statistically significant differences in the grade of differentiation,lymph node metastasis,TNM stage colorectal cancer patients with CTC positive,mCTC positive,and Ki-67 expression(P<0.05).The positive rate of mCTC in colorectal cancer patients with Ki-67≥60%was 73.85%,higher than that of 57.14%in patients with Ki-67<60%(P<0.05).Conclusion The positive rate of CTC and mCTC gradually increase with the progress of CRC,and m CTC may be involved in the blood metastasis of CRC.The expression of Ki-67 may be related to the positive rate of m CTC,and the two indicators would play an essential role in the development,metastasis,and prognostic evaluation of CRC.