循环肿瘤细胞监测与鼻咽癌适形放疗后复发转移预测的作用

Correlation Between Circulating Tumor Cell Monitoring and Recurrence and Metastasis of Nasopharyngeal Carcinoma After Conformal Radiotherapy

目的分析循环肿瘤细胞(circulating tumor cells,CTCs)监测与鼻咽癌术后适形放疗后复发转移预测的作用。方法抽取广东省罗定市人民医院2020年6月-2022年4月间收诊的50例III期至Ⅳa期的鼻咽癌患者,在其术后开展适形放疗,以流式细胞仪、抗体标记联合进行CTCs监测,对患者术后1周、术后1个月、术后3个月CTCs数量进行统计和分析,并对肿瘤复发转移的预测作用进行分析。结果①通过术后适形放疗,患者的阳性率显著降低,术后1周、术后1个月、术后3个月CTCs阳性率分别为84.00%(42/50)、56.00%(28/50)、26.00%(13/50),同阶段患者的CTCs数目持续降低,差异均有统计意义(P<0.05);②术后3个月,CTCs检测为阳性有13例,阴性为37例,阳性患者的总缓解率46.15%(6/13),显著低于阴性患者总缓解率97.30%(36/37),差异均有统计意义(P<0.05);③术后6个月CTCs阳性患者无新增转移率92.31%(12/13),与阴性患者94.59%(35/37)比较,差异无统计意义(P>0.05),术后12个月、24个月,CTCs检测阳性患者无新增转移率61.54%(8/13)、38.46%(5/13)均低于阴性患者91.89%(34/37)、86.49%(32/37),差异均有统计意义(P<0.05)。结论鼻咽癌患者在接受适形放疗后,采用CTCs监测能够有效的检测患者转归情况,并为医师对患者开展针对性治疗提供参考,对肿瘤复发具有预测作用,具有较高的推广价值。

Objective To analyze the role of circulating tumor cells(CTCs)monitoring and the prediction of recurrence and metastasis of nasopharyngeal carcinoma after conformal radiotherapy.Methods Fifty patients with nasopharyngeal carcinoma from stage III to StageⅳA admitted in our hospital from June 2020 to April 2022 were selected.Conformal radiotherapy was performed after surgery,and CTCs was monitored by flow cytometry and antibody labeling.The number of CTCs was statistically analyzed 1 week,1 month and 3 months after surgery.The prediction of tumor recurrence and metastasis was analyzed.Results①After postoperative conformal radiotherapy,the positive rate of patients was significantly reduced.The positive rate of CTCs was 84.00%(42/50),56.00%(28/50)and 26.00%(13/50)at 1 week,1 month and 3 months after surgery,respectively.The number of CTCs in patients at the same stage continued to decrease.The differences were statistically significant(P<0.05).②3 months after the operation,13 patients were positive and 37 were negative,and the total remission rate of positive patients was 46.15%(6/13),which was significantly lower than that of negative patients(97.30%),with statistical significance(P<0.05).③There was no significant difference between CTCs positive patients(92.31%,12/13)and negative patients(94.59%,35/37)6 months after surgery(P>0.05).12 months and 24 months after surgery,the rates of no new metastasis in CTCs positive patients 61.54%(8/13)and 38.46%(5/13)were lower than those in negative patients 91.89%(34/37)and 86.49%(32/37),and the differences were statistically significant(P<0.05).Conclusion CTCs monitoring for nasopharyngeal carcinoma patients after conformation radiotherapy can effectively detect the outcome of patients,provide reference for doctors to carry out targeted treatment for patients,and has a predictive role in tumor recurrence,with high promotion value.