循环肿瘤细胞和循环肿瘤内皮细胞计数对局限性肾癌术后复发转移监测的价值

The value of circulating tumor cell count and circulating tumor endothelial cell count in monitoring postoperative recurrence and metastasis of localized renal carcinoma

目的:探讨局限性肾癌患者行根治或部分切除术后循环肿瘤细胞和循环肿瘤内皮细胞数量变化在预测肿瘤复发转移中的作用。方法:收集52例局限性肾癌患者术前和术后3个月7.5 mL外周血和20例健康者7.5 mL外周血。术后循环肿瘤细胞数量和循环肿瘤内皮细胞数量高于术前者纳入阳性组,反之纳入阴性组。分别对两组患者进行随访,终点事件为肿瘤复发转移,最长随访时间21个月。结果:CTC阳性组复发转移率为61.9%(13/21),明显高于阴性组19.4%(6/31),差异有统计学意义(P=0.003),CTEC阳性组复发转移率为57.1%(12/21),阴性组复发转移率为22.6%(7/31),差异有统计学意义(P=0.012),双阳性组复发转移率为75.0%(12/16)。结论:术后3个月循环肿瘤细胞计数高于术前的肾癌患者易出现复发转移,若同时术后循环肿瘤内皮细胞计数高于术前,则提示患者复发转移率可能会更高。循环肿瘤细胞和循环肿瘤内皮细胞数量变化可作为较好的肾癌术后监测指标。

Objective:To investigate the role of the number of circulating tumor cells and circulating tumor endothelial cells in predicting the recurrence and metastasis of localized renal carcinoma after radical or partial nephrectomy.Methods:7.5 mL peripheral blood was collected from 52 patients with localized renal carcinoma before and 3 months after operation,and from 20 healthy patients.The number of circulating tumor cells and circulating endothelial cells after operation was higher than that before operation.Patients in the two groups were followed up,the end point was tumor recurrence and metastasis,and the longest follow-up time was 21 months.Results:The recurrence and metastasis rate in the CTC positive group was 61.9%(13/21),significantly higher than that in the negative group 19.4%(6/31),with statistically significant difference(P=0.003).The recurrence and metastasis rate in the CTEC positive group was 57.1%(12/21),the recurrence and metastasis rate in the negative group was 22.6%(7/31),with statistically significant difference(P=0.012),and the recurrence and metastasis rate in the double-positive group was 75.0%(12/16).Conclusion:Patients with renal carcinoma whose circulating tumor cell count was higher 3 months after surgery than that before surgery were prone to recurrence and metastasis.If the circulating tumor endothelial cell count was also higher than that before surgery,the recurrence and metastasis rate of patients might be higher.The changes in the number of circulating tumor cells and circulating tumor endothelial cells can be used as better monitoring indexes after renal carcinoma operation.