摘要
目的探讨结直肠癌患者外周血循环肿瘤细胞(CTCs)的检测及其临床病理诊断与预后意义。方法选取结直肠癌103例,分析CTCs阳性检出率与临床病理的关系,并采用Cox回归模型分析影响结直肠癌患者预后生存的危险因素。结果 CTCs阳性检出率为66.01%(68/103)。不同的临床分期、是否有肝转移的CTCs阳性检出率比较,差异有统计学意义(χ2分别=8.12、11.13,P均<0.05),在不同病理类型、分化程度、区域淋巴结转移、大体形态中CTCs阳性检出率差异均无统计学意义(χ2分别=0.06、0.02、3.44、0.92,P均>0.05);103例结直肠患者总生存期为1~68个月,中位生存期38.91个月;CTCs阳性组患者1年、3年、5年生存率分别为83.82%(57/68)、61.76%(42/68)、47.05%(32/68),经Log-rank检验明显低于CTCs阴性组91.42%(32/35)、82.85%(29/35)、74.28%(26/35),差异均有统计学意义(χ2分别=6.29、5.79、6.02,P均<0.05)。多因素Cox模型分析结果显示临床分期(Ⅲ~Ⅳ期)、肝转移(有)、区域淋巴结转移(有)、CTCs阳性是影响结直肠患者预后生存的危险因素(HR分别=3.49、3.06、3.39、2.77,P均<0.05)。结论 CTCs与结直肠癌患者临床分期、肝转移密切相关,术前CTCs阳性者预后较差,可通过检测CTCs对患者预后进行相关评估。
Objective To explore the expression of peripheral blood circulating tumor cells in patients with colorectal cancer and its clinical significance of pathological diagnosis and prognosis. Methods Totally 103 cases with colorectal cancer were selected. The relationship between the positive rate of CTCs and clinical pathology was analyzed. Cox regression model was used to analyze the prognostic factors for patients with colorectal cancer. Results In this study,the positive rate of CTCs was 66.01%（68/103）. The positive rates of CTCs were significantly different between the patients with clinical stageⅠ~Ⅱand Ⅲ~Ⅳ as well as whether combined with liver metastasis or not（χ2=8.12,11.13,P〈0.05）. The differences in CTCs positive rate among different pathological types,differentiation degree,regional lymph node metastasis,and shapes were not statistical significant（χ2=0.06,0.02,3.44,0.92,P〉0.05）. The survival time of103 cases with colorectal cancer was 1~68 months and the median survival time was 38.91 months. The one year,3 years,5 years survival rate of CTCs positive group were 83.82%（57/68）,61.76%（42/68） and 47.05%（32/68）respectively,which was significantly lower than those of CTCs negative group by the Log-rank test [91.42%（32/35）,82.85%（29/35）,74.28%（26/35）]（χ2=6.29,5.79,6.02,P〈0.05）. Cox multivariate analysis showed that clinical stage（III^IV）,Liver metastasis,regional lymph node metastasis and positive CTCs were risk factors for survival prognosis of colorectal cancer（HR=3.49,3.06,3.39,2.77,P〈0.05）. Conclusion CTCs is closely related to clinical stage and liver metastasis in patients with colorectal cancer. The prognosis of patients with CTCs positive before operation is poor,which can be evaluated by detecting CTCs.
作者
葛祖荫
石海权
郝敬铎
宋坤
GE Zuyin, SHI Haiquan, HAO Jingduo, et al.(Department of General Surgery, Zhenhai People’s Hospital of Ningbo, Ningbo 315200, Chin)
出处
《全科医学临床与教育》
2018年第5期501-504,共4页
Clinical Education of General Practice
基金
宁波市科技局项目(2015C50023)
关键词
结直肠癌
循环肿瘤细胞
预后
临床病理诊断
colorectal cancer
circulating tumor cell
prognosis
clinicopathological diagnosis
