血清CTCs、hs-CRP水平与肝癌手术患者预后的相关性研究

Correlation study of serum CTCs and hs-CRP levels with prognosis of patients undergoing hepatocellular carcinoma surgery

目的探究肝癌患者手术前后血清循环肿瘤细胞(CTCs)、血清超敏C反应蛋白(hs-CRP)水平变化,并分析其与预后的相关性。方法选取广东省茂名市人民医院2017年12月至2019年12月收治的60例原发性肝癌患者作为研究对象,同时选取30例健康体检者作为对照。患者分别于术前及术后不同时间点采集患者静脉血,应用CanPatrol技术测定CTCs数量,放免法检测血清hs-CRP水平,记录患者术后复发情况;同时,采用一元线性回归分析评估CTCs数量、hs-CRP水平与术后肝癌复发的相关性。结果肝癌患者术前,CTCs、hs-CRP及甲胎蛋白(AFP)水平显著高于健康者(P<0.05);肝癌患者术后,CTCs、hs-CRP及AFP水平较术前均显著降低(P<0.05),但高于健康者,其中CTCs数量与健康者比较差异有统计学意义(P<0.05)。确诊复发时患者CTCs、hs-CRP及AFP水平分别为(5.69±2.28)、(6.40±1.57)mg/L及(136.02±64.28)ng/mL,均显著高于术后1周相关水平(P<0.05),但均低于术前水平,其中CTCs及AFP与术前差异有统计学意义(P<0.05)。肝癌复发患者术前、术后及复发确诊时CTCs数量及hs-CRP水平与肿瘤标志物AFP均呈正相关(P<0.05)。结论肝癌复发患者CTCs及hs-CRP水平显著高于术后,且复发时CTCs数量及hs-CRP水平与肿瘤标志物AFP均呈正相关性,可联合检测CTCs数量及hs-CRP水平,帮助预测肝癌患者预后复发情况,促进临床诊疗。

【Objective】To investigate the changes of serum CTCs and hs-CRP levels in patients with liver cancer before and after surgery,and analyze the correlation between CTCs and prognosis.【Methods】Sixty patients with primary liver cancer admitted to our hospital were selected as the research object from December 2017 to December 2019.Venous blood sample was collected from patients at different time points before and after operation.The number of CTCs was measured by CanPatrol technology,and serum hs-CRP level was detected by radioimmunoassay.The postoperative recurrence was also recorded.At the same time,the correlation between the CTCs number,hs-CRP level and postoperative liver cancer recurrence was evaluated by single linear regression analysis.【Results】Before operation,the levels of CTCs,hs-CRP and AFP were significantly higher than those in the healthy group(P<0.05).After surgery,the levels of CTCs,hs-CRP and AFP in patients with liver cancer were significantly lower than those before surgery(P<0.05),but which was still higher than those in the healthy group.The number of CTCs was statistically different from that in the healthy group(P<0.05).The levels of CTCs,hs-CRP and AFP were 5.69±2.28,6.40±1.57 mg/L and 136.02±64.28 ng/mL,respectively,which were significantly higher than the relevant levels 1 week after operation(P<0.05),but lower than the levels before the operation.The differences between CTCs and AFP were statistically significant(P<0.05).CTCs number and hs-CRP level were positively correlated with the tumor marker AFP level before,after and at the time of diagnosis of HCC recurrence(P<0.05).【Conclusion】CTCs number and hs-CRP level of liver cancer patients were significantly higher than that of postoperative surgery after the recurrence.Meanwhile,CTCs number and hs-CRP level were positively related with the tumor markers AFP contents,which could help to predict the prognosis of patients with liver cancer relapse and promote the clinical diagnosis and treatment by jointly detecting CTCs number and hs-CRP level post surgery.