imFISH循环肿瘤细胞检测结果与恶性肿瘤患者临床特征及预后的关系

The relationship between imFISH circulating tumor cell detection results and clinical characteristics and prognosis of malignant tumor patients

目的探讨免疫荧光原位杂交(imFISH)循环肿瘤细胞(CTCs)检测结果与乳腺癌、肺癌、结直肠癌等恶性肿瘤临床特征和预后的关系。方法回顾性分析2018年6月至2020年11月于深圳市罗湖医院集团罗湖区人民医院就诊的恶性肿瘤患者共235例,涉及13个恶性肿瘤类型。分析CTCs阳性率和计数与患者所处的疾病阶段、临床分期、肿瘤标志物水平的关系,以及CTCs核体积变化与临床预后的关系。结果总CTCs阳性率为65.53%,复发转移患者CTCs阳性率为81.25%;未接受相关治疗患者CTCs阳性率(54.17%)与术后化疗患者阳性率(61.79%)比较,差异无统计学意义(χ^(2)=0.833,P=0.361)。CTCs阳性率与临床分期、病灶最大径、淋巴结转移、远处转移有关(P<0.05),而与癌胚抗原(CEA)、糖类抗原(CA)153、CA125等常见肿瘤标志物水平无关(P>0.05)。6例恶性肿瘤患者连续CTCs监测结果表明,疾病不同阶段的CTCs核体积及计数变化特点与疾病预后有关。结论imFISH CTCs检测阳性率与临床特征有关,核体积与临床预后相关,CTCs的检测对恶性肿瘤的预后判断有一定价值。

Objective To investigate the relationship between the detection results of circulating tumor cells(CTCs)by immunofluorescence in situ hybridization(imFISH)and the clinical characteristics and prognosis of breast cancer,lung cancer,colorectal cancer and other malignant tumors.Methods A total of 235 patients with malignant tumors who were treated in Shenzhen Luohu Hospital Group People′s Hospital from June 2018 to November 2020 were retrospectively analyzed,involving 13 types of malignant tumors.The relationship between the positive rate and count of CTCs and the disease stage,clinical stage,and tumor marker levels of the patients,as well as the relationship between the changes of CTCs nuclear volume and clinical prognosis were analyzed.Results The positive rate of total CTCs was 65.53%,and the positive rate of CTCs in patients with recurrence and metastasis was 81.25%;the positive rate of CTCs in patients who did not receive relevant treatment(54.17%)was not significantly different from that of patients with postoperative chemotherapy(61.79%,χ^(2)=0.833,P=0.361).The positive rate of CTCs was related to clinical stage,maximum diameter of lesions,lymph node metastasis and distant metastasis(P<0.05),but was not related to the levels of common tumor markers such as CEA,CA153,and CA125(P>0.05).The continuous monitoring of CTCs in 6 patients with malignant tumors showed that the changes in nuclear volume and number of CTCs in different stages of the disease were related to the prognosis of the disease.Conclusion The positive rate of imFISH CTCs detection is related to the clinical characteristics,and the nuclear volume is related to clinical prognosis.The detection of CTCs has certain value in the prognosis of malignant tumors.