Carcinoembryonic antigen expression and peanut agglutinin binding in primary breast cancer and lymph node metastases; lack of correlation with clinical, histopathological, biochemical and morphometric features

In a group of 335 patients with primary breast carcinoma the presence of immunoreactive carcinoembryonic antigen (CEA) and the binding of the lectin peanut agglutinin (PNA) in the primary carcinoma and in axillary lymph node metastases were investigated. The correlation between these results and a variety of established clinical, histopathologic, morphometric and biochemical prognosticators was studied. These features included lymph node status, tumour diameter, tumour type, nuclear grade, histologic grade, oestrogen receptor status, mitotic activity index and a number of nuclear measurements. The results indicate that CEA immunoreactivity of and PNA binding to tumour cells in primary breast carcinomas or lymph node metastases do not correlate with established prognostic factors in breast cancer.     

Carcinoembryonic antigen in fine-needle aspirate of liver: A diagnostic adjunct to cytology

Carcinoembryonic antigen (CEA) was measured in 50 consecutive fine-needle aspirates of liver to determine whether elevated levels could predict the presence of carcinoma in cytologically negative aspirates. There were 44 malignant and 6 benign lesions. The highest mean CEA values (591–672 ng/ml) were obtained in metastatic adenocarcinoma of the colon, stomach, and pancreas; lower levels (13.5–151 ng/ml) were found in metastatic carcinoma from the breast and lung. Carcinoid, hepatoma, Hodgkin's disease, and benign liver aspirates had low (<5 ng/ml) CEA levels. Cytologic diagnosis of malignancy was 96% sensitive and 100% specific. Using 5 ng as a cutoff for malignancy, the overall sensitivity of CEA for detection of malignancy was 77%; for detection of adenocarcinoma alone, sensitivity was 85%. Specificity was 100%. The CEA content of fine-needle aspirates generally exceeded serum values by 10–100-fold. Although CEA content did not enhance the sensitivity of cytologic diagnosis, it may suggest metastatic carcinoma of the GI tract in patients presenting with adenocarcinoma of an unknown primary source.     

Differential reactivities of carcinoembryonic antigen (CEA) and CEA-related monoclonal and polyclonal antibodies in common epithelial malignancies.

To evaluate the role of carcinoembryonic antigen (CEA) in solving problems of tumor histogenesis in surgical pathology, monoclonal antibodies to four distinct epitopes of CEA (E-Z-EM) were applied to paraffin sections of 303 epithelial neoplasms from multiple sites. Two epitopes were CEA specific (D14 and B7.1), one was shared with nonspecific cross-reacting antigen (NCA) (B7.8), and the fourth (B18) was common to CEA, NCA, and biliary glycoprotein antigen (BGP). A sample of the tumors (n = 110) was also stained with a polyclonal anti-CEA (DAKO). Gastrointestinal adenocarcinomas, including esophageal and gastric (n = 19), small intestinal (n = 8), colorectal (n = 56), biliary tract (n = 8), and pancreatic adenocarcinomas (n = 14), were consistently positive with all five antibodies. Other predominantly gland-forming carcinomas tested, comprising lung (n = 22), ovary (n = 18), and endometrium (n = 12), were either invariably negative with all five antibodies (endometrial adenocarcinoma, non-mucinous ovarian adenocarcinoma) or demonstrated selective and variable positivity (lung: D14, 50%; ovarian mucinous: D14, 50%). Among large polygonal cell carcinomas (hepatocellular carcinoma, renal cell carcinoma, melanoma, and adrenal carcinoma), only hepatomas stained positively, showing a distinctive canalicular staining pattern with the B18 (BGP epitope) (55%) and polyclonal antibody (50%). In the small polygonal cell carcinoma category, true CEA positivity was rare in breast (D14, 10% and B7.1, 14%) and never seen in prostatic carcinomas and carcinoid tumors. A subset of these breast (8 of 42), prostate (4 of 22), and carcinoids (4 of 7) showed exclusive positivity for the B18 antibody (NCA/BGP epitope). Ovarian serous papillary carcinomas (n = 14), papillary carcinomas of thyroid (n = 12), transitional cell carcinomas of the bladder (n = 11), and mesotheliomas (n = 3) were negative with all monoclonal antibodies. Metastatic carcinomas (n = 74) showed a similar pattern of reactivity to primary tumors. The authors conclude that CEA immunostaining may assist in identifying the histogenesis of epithelial tumors in several morphologic categories; that differential reactivities of the CEA monoclonal antibody panel exceed those of the polyclonal antibody; and that the discriminating power of the monoclonal panel is related to whether (1) CEA is or is not produced or (2) NCA or BGP is produced without concomitant CEA production. There is little evidence to support a concept of site-specific CEA species.     

肿瘤标志物CEA、CA15-3和CA125在乳腺癌化疗疗效评估中的价值

目的：探讨CEA、CA15-3以及CA125在监测乳腺癌化疗疗效评估中的价值。方法：选择2005年6月～2008年1月在我科行化疗的晚期乳腺癌患者共45例,采用化学发光法测定血清CEA、CA15-3和CA125水平。化疗方案采用标准FAC、AC-D、DA、XD、GC等方案。化疗临床疗效评价采用WHO标准,肿瘤标志物疗效评价标准参考Bac[1]等的方法。结果：治疗后CEA、CA15-3在完全缓解组（CR）和部分缓解组（PR）组出现明显减低、进展组（PD）组明显升高（P〈0.05）,而在稳定组（SD）组则无显著变化（P〉0.05）;CA125在CR和PR组出现显著降低（P〈0.05）,在SD、PD组治疗前后无显著变化（P〉0.05）。CEA、CA15-3、CA125以及三者联合进行的肿瘤标志物评价与临床疗效评价的总符合率分别为60.0%（27/45）、55.6%（25/45）、31.1%（14/45）和73%（33/45）。结论：CEA、CA15-3和CA125可较好地监测乳腺癌化疗疗效,三者联检将提高监测效果。     

Long-term prognosis of scar and non-scar cancers of the breast

The prognostic significance of histopathologic classification of ductal breast carcinoma as scar and non-scar types was studied among 311 patients with breast cancer, followed up for a minimum of 22 years after the diagnosis or until death. Ninety-six (31%) cancers were of scar type and they had a more favourable prognosis than the cancers of non-scar type (p = 0.0001). The scar cancers were more often well differentiated (p less than 0.0001), had more pronounced inflammatory cell reaction (p less than 0.0001), less nuclear pleomorphism (p less than 0.0001), less tumor necrosis (p less than 0.0001), and a lower mitotic rate (p less than 0.0001) than the non-scar cancers. It was less common for patients with scar cancer to have axillary lymph node metastases (p = 0.01) and their primary tumor was smaller (p = 0.006). In flow cytometric analysis the scar cancers were more often DNA diploid (p = 0.004) with S-phase fraction below the median (p = 0.0002). In a multivariate analysis the association of cancer with a scar did not appear as an independent prognostic factor, whereas histologic grade (p less than 0.001) and extent of tumor necrosis (p less than 0.001) did. We conclude that the classification of breast cancer as scar and non-scar types has less prognostic value than the conventional histopathologic grading.     

Molecular classification of breast carcinomas using tissue microarrays.

The histopathologic classification of breast cancer stratifies tumors based on tumor grade, stage, and type. Despite an overall correlation with survival, this classification is poorly predictive and tumors with identical grade and stage can have markedly contrasting outcomes. Recently, breast carcinomas have been classified by their gene expression profiles on frozen material. The validation of such a classification on formalin-fixed paraffin-embedded tumor archives linked to clinical information in a high-throughput fashion would have a major impact on clinical practice. The authors tested the ability of tumor tissue microarrays (TMAs) to sub-classify breast cancers using a TMA containing 107 breast cancers. The pattern of expression of 13 different protein biomarkers was assessed by immunohistochemistry and the multidimensional data was analyzed using an unsupervised two-dimensional clustering algorithm. This revealed distinct tumor clusters which divided into two main groups correlating with tumor grade (P<0.001) and nodal status (P = 0.04). None of the protein biomarkers tested could individually identify these groups. The biological significance of this classification is supported by its similarity with one derived from gene expression microarray analysis. Thus, molecular profiling of breast cancer using a limited number of protein biomarkers in TMAs can sub-classify tumors into clinically and biologically relevant subgroups.     

Diagnostic spectrum of ovarian masses in women with breast cancer; magnetic resonance imaging: histopathology correlation

This study addresses the clinical problem of the patient with breast cancer that has been operated on for an ovarian mass. It specifies the spectrum of histopathologic diagnoses and the differentiating magnetic resonance imaging (MRI) features of ovarian masses with correlations between clinical features, histopathologic, and MRI findings. Sensitivity and specificity of MRI vs histopathology in diagnosing malignancy are estimated. The study included 53 women with breast cancer who underwent surgery for an ovarian mass. Complete medical records, US and MRI images for the ovarian mass, and histopathology slides of both breast and ovarian resection specimens were reviewed and analyzed retrospectively. Thirty-six (67.9 %) patients had benign masses, and 17 (32.1%) had malignant masses, of which 8 (15.1%) were primary ovarian malignancies and 9 (17%) were metastatic from breast carcinomas. There was a significant association between benign and primary malignant ovarian masses and stage II breast cancer (P = .00). There was a significant association between metastatic ovarian masses and stage III to IV breast disease (P = .00) and negative estrogen receptor status (P = .05). Magnetic resonance imaging had a specificity of 91.7% and a sensitivity of 94.1% in diagnosing malignant ovarian masses. In conclusion, the spectrum of ovarian masses diagnosed in patients with breast cancer is broad, including benign lesions, primary ovarian malignancies, and breast metastases. Knowledge of the imaging features may allow a specific diagnosis aiding in surgical planning. Despite the high specificity and sensitivity of MRI to differentiate benign from malignant lesions, the unique ability to differentiate between primary and metastatic malignancies is conserved to histopathology.     

Estrogen receptor analysis on biopsies and fine-needle aspirates from human breast carcinoma. Correlation of biochemical and immunohistochemical methods using monoclonal antireceptor antibodies.

Monoclonal antibodies against estrogen receptor (ER) were used for determination of ER status immunocytochemically in histologic specimens from 192 primary breast carcinomas. All tumors were also assayed biochemically for ER with the dextran-coated charcoal method (DCC). The comparison of biochemically and immunocytochemically determined ER status showed concordant results in 80% (P less than 0.0001). In only 2 cases (1%) with low ER levels (less than 20 fmol/mg protein) immunocytochemistry failed to detect ER. ER positivity determined with a semiquantified approach based on intensity and heterogeneity of immunocytochemical staining correlated significantly with biochemically determined ER levels (P = 0.0001). In a series of fine-needle aspirates of 34 breast carcinomas sufficient cell material was available for ER immunocytochemistry (ER-ICA). Overall, the results of ER-ICA in fine-needle aspirates were concordant with ER-ICA in histologic specimens in 88% of the samples. In a few cases with weak positivity of ER-ICA in histologic specimens, ER-ICA was negative in fine-needle aspirates. In no case was there a false-positive immunocytochemical ER determination in a tumor aspirate. Thus, ER-ICA seems to be a reliable assay which can be performed in histologic and cytologic specimens.     

Histopathologic assessment of tumor regression after neoadjuvant chemotherapy in advanced-stage ovarian cancer

To date, no histopathologic criteria have been established to describe treatment response after neoadjuvant chemotherapy in ovarian cancer. The aim of this study was to identify histopathologic features of tumor regression in ovarian cancer specimens obtained after neoadjuvant chemotherapy regarding their ability to indicate treatment response. This study systematically evaluated histopathologic features of tumor regression in advanced-stage ovarian cancer treated with neoadjuvant chemotherapy (n = 49) and in a control group treated with primary surgery (n = 35). In addition, the largest tumor size was measured in the surgical specimens. Overall survival served as the reference standard with a median follow-up of 49 months. There was a significantly higher presence of regressive changes in the postchemotherapy group compared with the untreated control group (P < or = .04). The presence of scattered solitary tumor cells, fibrosis, foamy macrophages, and giant cells of foreign-body type each indicated previous neoadjuvant chemotherapy with high specificity (80.0%-100%) but with low sensitivity (18.4%-63.3%). Inflammatory cell infiltrates, isolated psammoma bodies, and hemosiderin were also associated with previous chemotherapy but with lower specificity. The presence of necrosis was significantly correlated with larger tumor size within the specimens (rho = 0.5, P < .0001) and was more often found in the control group. For both groups, the extent of regressive changes, evaluated as a single parameter or in combination, showed no correlation with overall survival. However, patients with absence of residual tumor, scattered solitary tumor cells, or residual tumor foci of 5 mm or less after neoadjuvant chemotherapy had a significantly longer median overall survival of 45.6 versus 27.3 months in patients with larger tumors (P = .02). Various histopathologic features generally associated with posttreatment changes did not allow differentiation of responding from nonresponding patients and provided no prognostic information. The residual tumor size after neoadjuvant chemotherapy was the only criterion significantly correlated with treatment response and subsequent overall survival.     

Combined detection of preoperative serum CEA,CA19-9 and CA242 improve prognostic prediction of surgically treated colorectal cancer patients

We assessed the prognostic significance of preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 242 (CA242) levels in surgically treated colorectal cancer patients. The relationship of preoperative serum CEA, CA19-9 and CA242 levels with disease characteristics was investigated in 310 patients. Correlation between tumor markers was investigated using Pearson correlation test. Univariate and multivariate survival analyses were used to study the relationship between preoperative tumor markers and prognosis [disease free survival (DFS) and overall survival (OS)]. Kaplan-Meier analysis with log rank test was used to assess the impact of tumor marker levels on survival. Positive rate of preoperative serum CEA, CA19-9 and CA242 were 54.84%, 47.42% and 37.10%, respectively. High preoperative CEA level was associated with tumor size (P = 0.038), T stage (P < 0.001) and AJCC stage (P = 0.002). High preoperative CA19-9 level was associated with tumor AJCC stage (P = 0.023). Preoperative CA242 positively correlated with CEA (P < 0.001) and CA19-9 (P < 0.001). Combining the three markers was of independent prognostic value in CRC (HR = 2.532, 95% CI: 1.400-4.579, P = 0.002 for OS; and HR = 2.366, 95% CI: 1.334-4.196, P = 0.003 for DFS). Combined detection of preoperative serum CEA, CA19-9 and CA242 is of independent prognostic value for management of CRC patients treated surgically.     

Interphase cytogenetics of chromosomes 11 and 17 in fine needle aspirates of breast cancer

The aims of this investigation were to compare quantitative with qualitative analysis of fluorescent in situ hybridization (FISH) centromere signals in interphase breast cancer cell nuclei and to evaluate the possible clinical utility of detecting numerical abnormalities of chromosomes 11 and 17 by FISH in the preoperative prediction of breast cancer histological grade. Commercial digoxigenin-labeled centromere probes to chromosomes 11 and 17 were hybridized to 69 malignant aspirates with histological follow-up. Aspirates were categorized as disomic or aneusomic for chromosomes 11 and 17 qualitatively; a subset of aspirates was also analyzed quantitatively. The quantitative and qualitative approaches resulted in almost identical categorisation. There was a significant association between the qualitative categorization of aspirates as aneusomic or disomic, the histological grade of the excised tumours (P = .0695, n = 69), and the cytological grade of the clinical aspirates (P = .006, n = 35). Although histological grade III tumors were almost invariably polysomic for one or both chromosomes, polysomy was also detected in grade I and II tumors. Qualitative FISH analysis was shown to be more sensitive than cytological grading in predicting histological grade III but was of lower specificity and was therefore not clinically useful.     

Immunocytochemical analysis of receptors for estrogen and progesterone in fine-needle aspirates from human breast carcinomas

Monoclonal antibodies were used for a preoperative analysis of estrogen receptors (ERs) and progesterone receptors (PgRs) in fine-needle aspirates from 44 primary human breast carcinomas. The semiquantitative receptor values obtained in cytologic specimens correlated well with those from enzyme immunoassay analysis on surgically removed tumor tissue (r = 0.74 for PgR; r = 0.75 for ER). Cytologic smears showed a heterogenous tumor cell distribution of ER and PgR in 29 and 23 cases, respectively. The results suggest that measurement of the ER and PgR in cytologic smears is an accurate and reliable technique that can be performed on a minimum amount of tissue.     

The role of epithelial antigens in diagnosis and staging of breast cancer

The study of different epithelial antigen expression has been performed in 183 breast cancers. In 73 patients regional lymph nodes were studied as well. Panepithelial antigen Egp-34 (Mab HEA-125) was expressed in 100% of primary tumors and metastases. Antigen MUC-1 (Mab ICO-25) was identified in 93% of breast cancers. Monomorphic type of expression in tumor cells was typical for Egp-34, MUC-1 being in certain cases expressed as a proportion of cells. Additional immunohistochemical study of regional lymph nodes with Mab to Egp34 and MUC-1 provides a 10% increase in the rate of breast cancer metastases detection compared to histological examination alone. The carcinoembryonic antigen (CEA) was useful in identification of metastases only in CEA-positive breast cancers.     

Diagnostic efficiency of carcinoembryonic antigen and CA125 in the cytological evaluation of effusions.

In our previous study, the combination of the concentrations of carcinoembryonic antigen (CEA) and CA125 and the findings from cytological examination in 189 benign and malignant pleural and peritoneal effusions was useful in the diagnosis/classification of malignant effusions. Sensitivity of CEA (level, greater than 5 ng/mL) was 68%; specificity was 99% for the diagnosis of malignant effusions secondary to carcinoma of the lung, breast, gastrointestinal tract, and mucinous carcinoma of the ovary. Sensitivity of CA125 (level, greater than 5000 U/mL) was 85%; specificity was 96% for the diagnosis of malignant effusions in carcinoma of the ovary, fallopian tube, and endometrium. We now expanded the study to include 840 pleural and peritoneal effusions (benign, n = 520; malignant, n = 320) and analyzed the data by the statistical method of Rudolph and colleagues. Based on new cutoff values, ie, CEA level at 6.3 ng/mL and CA125 level at 3652 U/mL, the sensitivities for detection of malignant effusions secondary to carcinomas of the lung, breast, and gastrointestinal tract and mucinous carcinoma of the ovary varied between 75% and 100%; specificity was 98%. Sensitivity of CA125 for detection of malignant effusions from müllerian epithelial carcinoma was 71%; specificity was 99%. The elevated CEA fluid level alone helped to diagnose malignant effusions of the gastrointestinal tract in 54%, breast in 19%, and lung in 16%. The high CA125 fluid level was predictive of müllerian epithelial carcinoma. Adjunctive use of CEA and CA125 levels in fluid enhances the sensitivity of cytological diagnosis and may be predictive of the primary site in patients who present with carcinoma of an unknown primary source.     

Serum IgE levels in patients with cancer

Serum levels of IgE and carcinoembryonic antigen (CEA) were determined in 100 patients with carcinoma of the breast and 81 with colon carcinoma in different stages of their disease. CEA levels reflected the stage of the disease and increased progressively from stage 1 to 4. In contrast, all patients regardless of their type of malignancy, stage of the disease, or CEA level had a similar IgE blood level which did not differ from that of the control group.     

乳腺超声光散射成像联合血清CA15-3、CEA检测在乳腺肿瘤中的诊断价值

目的 探究乳腺超声光散射成像与血清糖链抗原(CA15-3)、癌胚抗原(CEA)联合检测对乳腺肿瘤诊断的临床价值.方法 回顾性分析2014年1月至2016年1月我院收治的200例经术后病理学确诊为乳腺肿瘤患者的临床资料,其中乳腺癌、乳腺良性肿瘤患者各100例,另选取同期来我院进行体检的健康妇女50例作为对照组,对其临床资料进行回顾性分析.均采用超声光散射乳腺断层成像系统对总血红蛋白水平进行测量,同时采用化学发光免疫法对血清肿瘤标志物(CEA、CA15-3)水平进行检测.分析并比较三者联合检测与单一检测对乳腺肿瘤诊断的价值.结果 乳腺癌组的MHC测定值及血清CEA、CA15-3水平均高于乳腺良性肿瘤组及对照组,各项指标组间比较差异具有统计学意义(P<0.05);OPTIMUS联合血清CEA及CA15-3水平检测在乳腺癌中的检出阳性率最高,明显高于OPTIMUS、CEA及CA15-3三者的单独检测,差异具有统计学意义(P<0.05);OPTIMUS联合血清CEA、CA15-3水平检测诊断乳腺癌的灵敏度、准确率及阴性预测值分别为92.0%、94.0%、92.3%,均明显高于三者的单独检测,组间比较差异具有统计学意义(P<0.05).结论 乳腺超声光散射成像联合血清糖链抗原、癌胚抗原检测在乳腺肿瘤的诊断中具有重要的临床价值,可提高诊断灵敏度及准确率,值得在临床推广应用.     

Immunohistochemical detection of two small cell lung carcinoma-associated antigens defined by MAbs F12 and 123C3 in bronchoscopy biopsy tissues.

We have studied MAbs* for their ability to detect SCLC and differentiate this tumor type from the other lung tumor histotypes in cryostat sections of biopsy specimens taken at bronchoscopy from patients with suspected primary lung tumor disease. MAb F12, specific for the ganglioside fucosyl-GM1, reacted with 58% of the cases with SCLC (n = 19) and with less than 3% of those with non-SCLC (n = 38). MAb 123C3, specifically reactive with NCAM, reacted with 78% of the SCLC cases (n = 23). With this MAb no positive staining was seen in the non-SCLC cases (n = 41). None of the two MAbs reacted with tissue sections without tumor. In combined analysis with MAbs F12 and 123C3, all SCLC cases (n = 15) were positive with either and 47% with both of the MAbs. Our results show that both MAbs F12 and 123C3 are highly specific for SCLC in bronchoscopic biopsy tissue specimens, whereas the sensitivity for this histotype tends to be higher with MAb 123C3 than with F12 (P = 0.14). When used in combination, all SCLC cases could be identified. These MAbs may therefore be valuable as complements to current histopathologic characterization and differentiation of lung cancer.     

Fluorescent cytochemical detection of estrogen and progesterone receptors in breast fine-needle aspirates

Estrogen and progesterone receptors were studied in fine-needle aspiration biopsy specimens of 56 patients with primary, recurrent, or metastatic breast carcinoma. The ligands, 17 B-estradiol-6-carboxymethyloxine-bovine serum albumin fluorescein isothiocyanate (FITC-BSA estradiol) and hydroxyprogesterone hemisuccinate bovine serum albumin tetramethyl rhodamine isothiocyanate (TMRITC-BSA progesterone), were used in the fluorescent cytochemical method. The findings obtained from the aspirated cells with the use of the fluorescent cytochemical technique were compared with results obtained from the cell population of the same tumor after removal with the use of both the fluorescent cytochemical technique and the biochemical dextran-coated charcoal (DCC) assay. For the needle aspirates, there was 89% concordance for estrogen receptor and 86% concordance for progesterone receptor between biochemical and cytochemical results. A high degree of correlation was also demonstrated between fine-needle aspirates and imprint preparations with the use of the cytochemical technique. This study suggests that the fluorescent cytochemical technique is an effective tool in assessment of estrogen and progesterone receptor content in fine-needle aspirates of primary and metastatic breast cancer. The fluorescent cytochemical technique can be performed easily at community hospitals and is well suited for specimens of insufficient size for biochemical assay.     

结直肠癌术后循环肿瘤细胞检测的临床意义

目的 探讨结直肠癌(CRC)患者术后外周血循环肿瘤细胞(CTCs)阳性率及其计数与临床病理特征、肿瘤复发转移及预后之间的关系及其临床意义。方法 回顾性分析2016年1月—2017年7月上海交通大学医学院附属第九人民医院首诊并经病理确诊的99例CRC患者的临床资料,其中男66例、女33例,年龄37~79岁。检测患者术后4~8周且辅助治疗前CTCs计数和血清癌胚抗原(CEA)水平,随访患者生存情况,比较患者不同临床病理学特征患者间CTCs表达及计数值的统计学差异,包括性别、年龄、原发灶部位、肿瘤分化程度、原发灶浸润深度(T分期)、区域淋巴结侵袭程度(N分期)、远处转移(M分期)、TNM总分期;观察患者生存情况;采用COX比例风险回归模型进行无进展生存期、总生存期的单因素和多因素分析。结果 99例CRC患者CTCs阳性率为60.6%(60/99),CTCs计数值为0~24(4.909±5.518)。患者的CTCs阳性率和CTCs计数值在T1+T2+T3期、N0期、M0期、Ⅰ~Ⅱ期、CEA＜5 ng/mL和中高分化组患者低于T4期、N1+N2期、M1期、Ⅲ~Ⅳ期、CEA≥5 ng/mL、低分化组患者,差异均有统计学意义(P值均＜0.05)。患者随访3~20个月,死亡22例(22/99,22.2%),其中CTCs阳性21例;疾病进展32例(32/99,32.3%),其中CTCs阳性29例。单因素分析显示:CTCs表达、N分期、M分期、肿瘤分期、和高CEA水平是无进展生存期的影响因素(P值均＜0.05);CTCs表达、N分期、M分期、肿瘤原发灶位于直肠、高CEA水平是总生存期的影响因素(P值均＜0.05)。CTCs和远处转移是CRC患者无进展生存期和总生存期的独立预后因素(HR= 5.418、2.254,95%可信区间:1.595~8.403、1.227~7.986,P值均＜0.05)。结论 在术后CRC患者中,CTCs表达与预后不良有关,对肿瘤复发转移评估具有一定的价值和临床意义。