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胰腺癌根治术患者外周血CTCs水平与病理参数及预后的相关性
程柳,余芃,吴孟航,王浩,李蕊利
0
(四川大学华西医院肝脏外科)
摘要:
【摘要】目的 探讨胰腺癌根治术患者外周血循环肿瘤细胞(CTCs)水平与病理参数及预后的相关性。方法 选择2017年3月~2018年3月于我院行胰腺癌根治术的患者98例,选择同时期于我院体检的35例健康志愿者为对照组。采集外周血75 mL,用免疫磁珠负性富集和免疫荧光原位杂交技术检测CTCs水平。分析胰腺癌患者外周血CTCs水平与病理特征的相关性,用KaplanMeier生存分析比较外周血CTCs阳性、阴性患者的生存时间,影响预后的多因素分析采取COX风险比例模型。结果 胰腺癌患者外周血中CTCs的阳性检出率为6327%(62/98),检测数量0~27个,平均201个/ mL,对照组未检出CTCs阳性;Logistic回归分析结果显示,淋巴结转移、侵犯被膜是外周血CTCs阳性的独立危险因素(P<005);KaplanMeier生存分析结果显示,CTCs阳性患者1年生存率为16133%,中位生存时间为245 d,CTCs阴性患者1年生存率为4722%,中位生存时间为352 d,两组比较差异有统计学意义(P=00004);COX回归分析结果显示,CTCs阳性、淋巴结转移是导致预后不佳的独立危险因素(P<005)。结论 胰腺癌患者外周血中CTCs检出率较高,其水平与淋巴结转移等病理特征相关,对预后也有一定的预测作用,检测外周血CTCs对胰腺癌的治疗有具指导意义。
关键词:  胰腺癌  外周血  循环肿瘤细胞  病理特征  生存分析
DOI:
基金项目:
Correlation between peripheral blood CTCs level, pathological parameters and prognosis in patients undergoing radical resection of pancreatic cancer
CHENG Liu,YU Pen,WU Menghang,WANG Hao,LI Ruili
(Department of Liver Surgery, West China Hospital, Sichuan University)
Abstract:
【Abstract】Objective To investigate the correlation between the level of peripheral blood circulating tumor cells (CTCs) and pathological parameters and prognosis in patients undergoing radical resection of pancreatic cancer. Methods 98 patients underwent radical resection of pancreatic cancer in our hospital from March 2017 to March 2018 were selected. Another 35 healthy volunteers admitted to our hospital for physical examination at the same time were selected as control group. 7.5 ml peripheral blood was collected, and the level of CTCs was detected by immunomagnetic negative enrichment and immunofluorescence in situ hybridization. The correlation between level of peripheral blood CTCs and pathological features was analyzed among patients with pancreatic cancer. The survival time of patients with positive and negative peripheral blood CTCs was compared by KaplanMeier survival analysis. Multivariate analysis of prognosis was performed by COX proportional hazard model. Results The positive detection rate of CTCs in peripheral blood of patients with pancreatic cancer was 6327% (62/98), the number of detection was 027 with an average of 2.01/ml, and no positive CTCs were detected in control group. Logistic regression analysis showed that lymph node metastasis and envelope invasion were independent risk factors for positive peripheral blood CTCs (P<005). KaplanMeier survival analysis showed that the 1year survival rate and median survival time were 16133% and 245d among patients with positive CTCs, and were 4722% and 352d among patients with negative CTCs (P=00004). COX regression analysis showed that positive CTCs and lymph node metastasis were independent risk factors for poor prognosis (P<005). ConclusionThe detection rate of CTCs in peripheral blood is higher among patients with pancreatic cancer, and its level is related to pathological features such as lymph node metastasis. It also has a certain predictive effect on prognosis. Detection of peripheral blood CTCs has guiding significance in the treatment of pancreatic cancer.
Key words:  Pancreatic cancer  Peripheral blood  Circulating tumor cells  Pathological features  Survival analysis

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