皮肤肿瘤患者外周血循环肿瘤细胞与循环肿瘤血管内皮细胞检测的临床价值

Significance of CTC and CTEC values in the peripheral blood of subjects with skin tumors

目的探究循环肿瘤细胞(CTC)与循环肿瘤血管内皮细胞(CTEC)检测在皮肤恶性肿瘤中的临床运用价值。方法采用差相富集-免疫荧光染色结合染色体荧光原位杂交(SE-iFISH)方法检测5例皮肤恶性肿瘤患者(肿瘤组)以及14例健康人(健康组)外周血中CTC及CTEC数量,计算检出率,分析肿瘤组CTC/CTEC的亚类分型特征以及CTC/CTEC数量与患者临床特征的相关性。结果肿瘤组CTC及CTEC阳性检出率均为100%,外周血中CTC平均值为(6.93±8.18)个/mL,CTEC平均值为(1.60±1.03)个/mL;健康组CTC及CTEC阳性检出率均为64%,外周血中CTC平均(0.19±0.21)个/mL,CTEC平均(0.30±0.33)个/mL。肿瘤直径较大、伴淋巴结转移、临床分期为Ⅲ、Ⅳ期患者CTC及CTEC水平较高。肿瘤患者大细胞CTC占总数的88.46%(184/208),大细胞CTEC占总数的81.25%(39/48),且主要为≥五倍体CTC和CTEC。结论皮肤肿瘤患者CTC/CTEC检出率较高;CTC及CTEC数量与患者临床特征具有密切关系;皮肤肿瘤外周血中大细胞多倍体CTC和CTEC比例高于其他亚型。

Objective To investigate the clinical utility of identifying circulating tumor cells(CTC)and circulating tumorigenic endothelial cells(CTEC)in skin malignancies.Methods Subtraction enrichment-immunostaining and fluorescence in situ hybridization(SE-iFISH)were used to detect the number of CTC and CTEC in the peripheral blood of 5 patients with skin tumor(tumor group)and 14 healthy individuals(healthy controls),and the detection rate was calculated.The subtype characteristics of CTC/CTEC and the correlation between the number of CTC/CTEC and the clinical characteristics of the patients were analyzed.Results The positive rates of CTC and CTEC in the tumor group were 100%.The average CTC were(6.93±8.18)/mL and CTEC were(1.60±1.03)/mL in the peripheral blood of the tumor group.The positive rates of CTC and CTEC in the healthy controls were both 64%.The average CTC were(0.19±0.21)/mL,and CTEC were(0.30±0.33)/mL in the peripheral blood of the healthy controls.Patients with larger diameter of tumor,lymph node metastasis,and clinical stages of III and IV had higher levels of CTC and CTEC;Large CTC accounted for 88.46%(184/208)of the total tumor cells,while large CTEC accounted for 81.25%(39/48)of the total tumor cells,which mainly were≥pentaploid CTC and CTEC.Conclusions Using SE-iFISH,the detection rates of CTC/CTEC are high in patients with skin tumors.The amounts of CTC and CTEC are correlated with the clinical features of patients.A higher proportion of CTC and CTEC is large multiploid cells in peripheral blood of subjects with skin tumors.