胃癌循环肿瘤细胞干细胞特性的研究

目的通过检测胃癌循环肿瘤细胞(CTC)是否表达CD44,判断CD44~+CTC与胃癌预后关系,并探讨CD44~+CTC是否具有胃癌干细胞的某些特性。方法选择2013年8月至2015年10月就诊于安徽医科大学附属第一医院的60位胃癌患者(试验组),入院后第2天清晨抽取空腹静脉血5 m L;选取同期体检中心30位健康志愿者为对照组,抽取清晨空腹静脉血5 m L。采用密度梯度离心联合免疫磁性阴性富集及免疫荧光原位杂交法检测试验组和对照组CTC水平及CD44~+CTC。随访获得试验组患者术后生存情况,比较试验组CD44~-CTC患者和CD44~+CTC患者的预后。结果试验组CTC阳性率为73.3%(44/60),对照组未检测出。试验组有29例检测出CD44~+CTC,CD44~+CTC胃癌患者平均生存时间[(30.9±5.6)月]较CD44~-CTC患者[(36.8±4.6)月]短(P<0.05)。结论胃癌CTC可表达CD44,胃癌CD44~+CTC可能由于具有胃癌干细胞的某些特性而造成胃癌的不良预后。

Research on stem cell characteristics of circulating tumor cells in gastric cancer

Objective To explore whether CD44⁺CTC has certain characteristics of gastric cancer stem cells by detecting the expression of CD44 in gastric cancer circulating tumor cells (CTC) and analyzing the prognosis of CD44⁺CTC in gastric cancer. Methods From August 2013 to October 2015, 60 patients with gastric cancer admitted to the First Affiliated Hospital of Anhui Medical University were selected as the experimental group, in which 5 mL fasting peripheral venous blood for each patient was drawn in the morning of the second day after admission, and another 30 healthy volunteers in the same time period were as control group and 5mL morning fasting peripheral venous blood was drawn. Density gradient centrifugation combined with immunomagnetic negative enrichment and immunofluorescence in situ hybridization were used to detect CTC and CD44⁺CTC in experimental group and control group. The postoperative survival of patients with gastric cancer in experimental group was followed up for comparison of the prognosis of patients with CD44^-CTC and CD44⁺CTC in experimental group. Results The positive rate of CTC test in experimental group (44/60, 73.3%) was higher than that in control group (0, P<0.05); the difference was statistically significant. In experimental group, CD44⁺CTC was detected in 29 cases. The mean survival time of CD44⁺CTC patients with gastric cancer[(30.9±5.6) months] was shorter than that of patients with CD44^-CTC[(36.8±4.6) months](P<0.05). Conclusion Gastric cancer CTC can express CD44. Gastric cancer CD44⁺CTC may have certain characteristics of gastric cancer stem cells and cause poor prognosis of gastric cancer.