摘要
目的探讨循环肿瘤细胞的数目、分型与子宫内膜癌患者临床病理特征的关系。方法收集就诊的子宫内膜癌患者83例,与同期就诊的宫体良性肿瘤患者11例作为对照。采用CanPatrol^TM CTCs技术检测血液中的CTCs,并分析其数目、分型及其与临床病理特征之间的关系。结果(1)在宫体良性肿瘤患者中,仅混合型CTCs被检出(4/11);在子宫内膜癌患者中,CTCs总检出率高达95.2%(79/83),CTCs总数、上皮型CTCs、混合型CTCs、间质型CTCs相应的中位数分别为:6.00个、0.00个、3.00个、1.00个。与宫体良性肿瘤患者对比,子宫内膜癌患者CTCs总数、上皮型CTCs、混合型CTCs、间质型CTCs均较高,差异有统计学意义(P<0.05)。(2)分析发现,当CTCs总数>1、上皮型CTCs>0、混合型CTCs>1、间质型CTCs>0时,是诊断子宫内膜癌与宫体良性病变的临界值,其诊断的敏感度为97.37%,特异度为50.00%,准确度为83.30%,阳性预测值为89.16%。(3)进一步分析各分型CTC数在子宫内膜癌患者的临床病例特征中发现,在术前肿瘤标志物包括CA125水平及CA199水平、分期、分型、分级、以及是否脉管浸润、神经侵犯、深肌层、宫颈侵犯、附件转移、淋巴结转移、腹水情况,差异无明显统计学意义。结论采用CanPatrol^TM CTC技术检测子宫内膜癌患者CTCs检出率高,但其在良性患者中,仍有一定的假阳性率,通过上调CTCs阈值,可提高诊断子宫良恶性病变的敏感性,但其准确度、特异度仍较低。笔者未发现CanPatrol^TM CTCs技术检测各分型CTCs数目与子宫内膜癌临床病例特征有相关性。因此我们认为,CanPatrol TM CTCs检测技术在子宫内膜癌的应用仍有待进一步改进。
Objective To investigate the number and phenotype of peripheral blood circulation tumor cells(CTCs)in patients with endometrial cancer and its correlation with clinicopathological characteristic.Methods Eighty-three cases of endometrial carcinoma and 11 cases with benign uterine disease were included.All cases were pathologically proven.CanPatrol^TM CTC detection technology was applied to detect CTCs numbers and typing,and their correlation with clinicopathological characteristic.Results Only mixed type CTCs was detected in patients with benign lesions(4/11).As for endometrial cancer,the rate was as high as 95.2%(72/83),and the median of the total CTCs,epithelial type CTCs,mixed type CTCs and interstitial type CTCs were 6.00,0.00,3.00 and 1.00,respectively.Compared with benign lesions in the uterus,the number of total CTCs in the endometrial carcinoma cases was significantly higher,so were epithelial type CTCs,mixed type CTCs,and interstitial type CTCs(P<0.05).When the total number of CTCs was>1,epithelial CTCs>0,mixed CTCs>1,and stromal CTCs>0,were selected as the cutoff value for the diagnosis of endometrial cancer from uterine benign lesions;the diagnostic sensitivity was 97.37%,specificity was 50.00%,accuracy was 83.30%,and positive predictive value was 89.16%.There was no significant difference in CTCs count or phenotype among patients with different CA125,CA199,staging,classification and grading,vascular infiltration,nerve invasion,deep muscularis invasion,cervical invasion,attachment metastasis,lymph node metastasis or ascites invasion.Conclusion The detection rate of CTCs in endometrial carcinoma is high using CanPatrol^TM.No correlation is found of CTC number and phenotype with clinicopathological characteristic.Therefore,the application of CanPatrol^TM CTCs in endometrial cancer remains to be improved.
作者
黄珊瑜
李小毛
叶辉霞
丁杰
方莉
HUANG Shan-yu;LI Xiao-mao;YE Hui-xia;DING Jie;FANG Li(Department of Gynecology,the Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,Guangdong,China)
出处
《广东医学》
CAS
2020年第3期252-256,共5页
Guangdong Medical Journal
关键词
子宫内膜癌
分型
循环肿瘤细胞
临床病理特征
endometrial carcinoma
phenotype
circulation tumor cells
clinicopathological characteristic
