摘要
目的观察循环肿瘤细胞(CTCs)数量与中药参与治疗的晚期非小细胞肺癌(NSCLC)患者预后的相关性,并进一步分析不同CTCs条件下不同治疗方式对生存时间的影响。方法选择2016年3月至2017年3月中国中医科学院广安门医院收治的63例晚期NSCLC患者为研究对象,按照治疗方法不同分为中医组(33例)和中西医结合组(30例),分别接受中医治疗和中西医结合治疗。每组患者在常规治疗及评价的基础上,采用免疫磁珠阴性分选法检测血液中CTCs的数量,同时随访患者的总生存期(OS)及疾病无进展生存期(PFS),分析晚期NSCLC患者血液中CTCs数量与患者预后的相关性;分析不同CTCs数量条件下不同治疗方式与OS的相关性。结果基线CTCs临床分期、影像学评价、KPS评分为患者总生存的影响因素(P<0.05)。CTCs数量>5个的患者,平均OS为228.10 d(95%CI 204.47~251.73),中位OS为236.00 d(95%CI 185.44~285.56);CTCs数量≤5个的患者,平均OS为339.70 d(95%CI 331.12~348.29),CTCs数量>5个的患者OS短于CTCs数量≤5个的患者(P<0.01)。第一周期治疗后CTCs数量>5个的患者平均PFS为81.63 d(95%CI 63.87~99.38),中位PFS为64.00 d(95%CI 58.46~69.54);而CTCs数量≤5个的患者平均PFS为167.42 d(95%CI 145.39~189.45),中位PFS为172.00 d(95%CI 158.42~185.58),CTCs数量>5个的患者PFS短于CTCs数量≤5个的患者(P<0.01)。进一步分析显示,基线CTCs数量≤5个和>5个两组,中医组和中西医结合组生存曲线比较差异均无统计学意义(P>0.05)。结论CTCs数量对中医药参与治疗的晚期NSCLC患者的OS和PFS有很好的预测价值,是一个独立的预后因素;当CTCs数量>5个时,中西医结合治疗展示了生存优势的趋势。
Objective To observe the relationship between the number of circulating tumor cells(CTCs)and the prognosis of patients with advanced non-small cell lung cancer(NSCLC)treated with participation of traditional Chinese medicine,and analyze the effects of different treatment methods on the survival with different CTCs.Methods A total of 63 patients with advanced NSCLC admitted to Guang′anmen Hospital,Chinese Academy of Traditional Chinese Medicine from Mar.2016 to Mar.2017 were included in the study,and were divided into a traditional Chinese medicine group(33 cases)and a traditional Chinese medicine plus western medicine group(30 cases)according to the treatment method.On the basis of routine treatment and evaluation,the number of CTCs was detected by immunomagnetic bead negative sorting.At the same time,the overall survival(OS)time and progression free survival(PFS)time of the patients were followed up,and the predictive value of the number of CTCs in the blood of patients with advanced NSCLC was analyzed,and the correlation between OS and different treatment methods under different number of CTCs was analyzed.Results Baseline CTCs,clinical staging,imaging evaluation,and KPS score were the influencing factors for OS of the patients(P<0.05).For patients with CTCs>5,the average OS was 228.10 d(95%CI 204.47-251.73),and median OS was 236.00 d(95%CI 185.44-285.56);for patients with CTCs≤5,the average OS was 339.70 d(95%CI 331.12-348.29),the OS of patients with CTCs>5 was shorter than that of patients with CTCs≤5(P<0.01).The patients with the number of CTCs>5 after the first cycle of treatment had an average PFS of 81.63 d(95%CI 63.87-99.38)and a median PFS of 64.00 d(95%CI 58.46-69.54);and the patients with the number of CTCs≤5 had an average PFS of 167.42 d(95%CI 145.39-189.45),and a median PFS of 172.00 d(95%CI 158.42-185.58),and patients with CTCs>5 had shorter PFS than the patients with CTCs≤5(P<0.01).Further analysis showed that in the two groups of baseline CTCs≤5 and>5,there was no significant difference in survival curves between the traditional Chinese medicine group and the traditional Chinese medicine plus western medicine group(P>0.05).Conclusion The number of CTCs has a good predictive value for the survival of patients with advanced NSCLC treated by participation of traditional Chinese medicine,and is an independent prognostic factor.When the number of CTCs is>5,traditional Chinese medicine plus western medicine shows advantage in OS.
作者
秦英刚
花宝金
QIN Yinggang;HUA Baojin(Department of Oncology,Guang′anmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100053,China)
出处
《医学综述》
2020年第14期2844-2849,共6页
Medical Recapitulate
基金
国家科技支撑计划(2014BAI10B00)。
关键词
晚期非小细胞肺癌
循环肿瘤细胞
中医药
生存预测
Advanced non-small cell lung cancer
Circulating tumor cells
Traditional Chinese medicine
Survival prediction
