胰腺癌患者外周血循环肿瘤细胞ARK5表达与吉西他滨化疗疗效及预后的相关性

Correlation of ARK5 expression in peripheral blood circulating tumor cells with curative efficacy and prognosis for gemcitabine chemotherapy in pancreatic cancer patients

目的检测胰腺癌患者外周血循环肿瘤细胞(CTCs)ARK5的表达,探讨其与胰腺癌患者吉西他滨化疗疗效及预后的相关性。方法收集2016年1月至2021年6月嘉兴学院附属第二医院肝胆外科收治的175例胰腺癌患者外周血标本。运用纳米微流控芯片技术富集CTCs,采用免疫荧光法检测CTCs ARK5的表达。依据ARK5表达情况分为阳性组和阴性组,比较两组患者临床资料、吉西他滨化疗疗效、中位生存期和无进展生存期的差异。结果175例患者中98例(55.6%)富集到CTCs,其中ARK5阳性组70例,阴性组28例,两组患者临床资料的差异均无统计学意义,具有可比性。70例ARK5阳性组患者中64例(91.4%)对吉西他滨产生了耐药性,28例ARK5阴性组患者中12例(42.8%)对吉西他滨产生耐药性,ARK5阳性组吉西他滨耐药发生率显著高于阴性组,差异有统计学意义(P<0.001)。ARK5阳性组患者中位生存期为11.5个月,阴性组为14个月;ARK5阳性组无进展生存期为6个月,阴性组为8个月,ARK5阳性组生存期显著短于阴性组,差异有统计学意义(P<0.05)。结论CTCs ARK5阳性表达的胰腺癌患者对吉西他滨化疗耐药发生率显著高于阴性患者,生存时间显著低于阴性患者,检测CTCs的ARK5表达有可能作为判断胰腺癌患者化疗疗效及预后的一种新方法。

Objective To detect the expression of ARK5 in peripheral blood circulating tumor cells(CTCs)from pancreatic cancer patients and explore its correlation with the efficacy and prognosis for gemcitabine chemotherapy.Methods A total of 175 peripheral blood samples of pancreatic cancer patients who were treated in the Department of Hepatobiliary Surgery,Second Affiliated Hospital of Jiaxing University from January 2016 to June 2021 were collected.CTCs were enriched by nano-microfluidic chip technology.The expression of ARK5 in CTCs was detected by immunofluorescence.According to the expression of ARK5,the patients were divided into two groups:positive group and negative group.The differences on clinicopathological features,the efficacy of chemotherapy,median survival and progression-free survival time between the two groups were compared.Results CTCs were enriched in 98 of 175 patients(55.6%),including 70 ARK5 positive and 28 ARK5 negative patients.There were no significant differences on clinical features between the two groups,and the two groups were comparable.In the 70 ARK5 positive patients,64 patients(91.4%)were resistant to gemcitabine,while only 12 of the 28 ARK5 negative patients(42.8%)were resistant to gemcitabine.The incidence of gemcitabine resistance in ARK5 positive patients was significantly higher than that in ARK5 negative patients,and the difference was statistically significant(P<0.001).The median survival time was 11.5 months in ARK5 positive group and 14 months in ARK5 negative expression group,and the progression-free survival time was 6 months in ARK5 positive expression group and 8 months in negative expression group.The survival time of ARK5 positive group was significantly shorter than that of ARK5 negative group,and the difference was statistically significant(P<0.05).Conclusions The pancreatic cancer patients with ARK5 positive CTCs have significantly higher incidence of gemcitabine resistance and shorter survival time than those with ARK5 negative CTCs.Detection of ARK5 expression in CTCs may be a new method to judge chemotherapy efficacy and prognosis for pancreatic cancer patients.