老年食管胃交界腺癌患者循环肿瘤细胞检测的临床意义

Clinical significance of circulating tumor cell detection in elderly patients with esophagogastric gastric junction adenocarcinoma

目的通过检测老年食管胃交界腺癌(AEG)患者外周血中的循环肿瘤细胞(CTCs),探讨CTCs与老年AEG患者临床特征及预后的关系。方法回顾性分析聊城市人民医院2016年8月至2020年5月95例老年AEG患者的临床资料,治疗前的1周均采用阴性富集-免疫荧光原位杂交技术(NE-FISH)检测CTCs,分析CTCs计数阳性与患者临床特征的关系,通过随访获取老年AEG患者无进展生存期(PFS)及总生存期(OS),采用Kaplan-Meier法进行生存分析,Cox回归分析CTCs计数与老年AEG患者预后指标(PFS、OS)的关系。结果95例老年AEG患者CTCs阳性(CTCs≥2)率为72.6%(69/95)。老年AEG患者CTCs阳性与患者脉管内瘤栓、TNM病理分期、T分期、淋巴结转移、是否手术均密切相关(P<0.05)。Kaplan-Meier生存分析示,与CTCs<2组比较,CTCs≥2组老年AEG患者中位PFS(12个月vs 50个月)及中位OS更短(20个月vs 50个月),差异有统计学意义(P<0.01)。结论运用NE-FISH技术对老年AEG患者行外周血CTCs检测是可行的,CTCs阳性与老年AEG患者肿瘤转移、病情进展密切相关,CTCs≥2可能是老年AEG患者预后不良的预测指标。

Objective To investigate the relationship between circulating tumor cells(CTCs)and clinical characteristics and prognosis of elderly patients with esophagogastric junction adenocarcinoma(AEG)by detecting CTCs in their peripheral blood.Methods A retrospective analysis was conducted on 95 elderly AEG patients at Liaocheng People's Hospital from August 2016 to May 2020.Negative enrichment-immuno fluorescence in situ hybridization(NE-FISH)was used to detect CTCs one week before treatment.The relationship between positive CTCs count and clinical characteristics of patients was analyzed.Progression free survival(PFS)and overall survival(OS)of elderly AEG patients were obtained through follow-up,and survival analysis was performed using Kaplan-Meier method.Cox regression analysis was used to analyze the relationship between CTCs count and prognostic indicators(PFS,OS)in elderly AEG patients.Results The positive rate of CTCs(≥2)in 95 elderly AEG patients was 72.6%(69/95).The positivity of CTCs in elderly AEG patients was closely related to TNM pathological staging,T staging,lymph node metastasis,and surgery(P<0.05).Kaplan Meier survival analysis showed that,compared with the CTCs<2 group,the median PFS(12 months vs 50 months)and median OS(20 months vs 50 months)of elderly AEG patients in the CTCs≥2 group were shorter and the differences were statistically significant(P<0.01).Conclusion The use of NE-FISH technology for peripheral blood CTCs detection in elderly AEG patients is feasible.Positive CTCs are closely related to tumor metastasis and disease progression in elderly AEG patients,and CTCs≥2 may be an indicator of poor prognosis in elderly AEG patients.