循环肿瘤细胞对结直肠癌预后的相关性研究

目的 研究分析肥大细胞三种亚型对结直肠癌预后可能产生的影响,从而发现肥大细胞对结直肠癌预后的影响因素,为临床指导治疗提供理论依据.方法 选择2011年资料完整的结直肠癌根治术后石蜡标本40例作为试验组,术前未放疗或化疗;另取20例正常大肠组织,作为对照组,采用双重免疫组化技术对试验组做连续切片进行染色,观察2组中各亚型构成比是否有差异.计算出40例结直肠癌患者切片中各亚型的总平均计数值,与试验组每张切片相对应的平均计数值进行比较,观察肥大细胞各亚型的数量与性别、癌的分化程度、癌的浸润深度、淋巴结转移及生存时间的关系,并总结肥大细胞三种亚型与结直肠癌之间的关系.结果 TIM在结直肠癌根治术后石蜡标本有不同程度的浸润,2组的在结直肠癌的N分期和TNM分期及肿瘤分化程度方面差异有统计学意义(P<0.05).高计数组和低计数组5年总生存率和无瘤生存率分别为63.1%、59.3%和82.9%、79.0%,2组比较差异有统计学意义(P<0.05).COX比例风险模型单因素分析结果显示,在肿瘤组织中,肥大细的浸润是对结直肠癌患者总生存时间和无瘤生存时间造成影响的不良因素,后续多因素分析得出,对结直肠癌患者总生存时间、无瘤生存时间而言,浸润肥大细胞为其独立影响因素(P<0.05).结论 TIM与结直肠癌的N分期和TNM分期相关,循环肿瘤细胞可影响结直肠癌患者预后,所以可借助对循环肿瘤细胞的检测,去对结直肠癌患者的生存预后进行预测,提高患者的预后及生存率.

Correlation of circulating tumor cells and the prognosis of patients with colorectal cancer

Objective To investigate the effects of three subtypes of mast cells (TIM) on the prognosis of patients with colorectal carcinoma in order to find the influencing factors of mast cells on the prognosis of colorectal cancer,so as to provide theoretical basis for guiding clinical treatment of rectal cancer.Methods The 40 specimens of radical resection of colorectal cancer with complete clinical data in 2011 were selected as experimental group,without preoperative radiotherapy or chemotherapy,and the other 20 cases of normal colorectal tissues were served as control group.The differences of subtypes were observed by using double immunohistochemical technique continuous slices staining.The correlation between the numbers of different subtypes of mast cells and patient's sex, differentiation degree of cancer, invasion depth, lymph node metastasis,patient's survival time was analyzed,moreover, the correlation between the three subtypes of mast cell and colorectal cancer was investigated.Results The TIM had different degree infiltration in paraffin-embeded specimens after radical resection of colorectal cancer,there were significant differences in N staging and TNM staging of colorectal cancer between two groups (P<0.05).The 5-year total survival rates and tumor-free survival rate in high counting group and low counting group were 63.1%, 59.3% and 82.9%, 79%,respectively,there were significant differences between two groups (P<0.05).The single factor analysis of COX proportional hazards model showed that in tumor tissue, infiltration of mast cells was adverse factors influencing overall survival time and tumor-free survival time of patients with colorectal cancer.Moreover multiple factor analysis showed mast cells infiltration was independent influencing factors on overall survival time and tumor-free survival time of patients with colorectal cancer (P<0.05).Conclusion TIM is closely correlated to N staging and TNM staging of colorectal cancer,and circulating tumor cells can influence the prognosis of patients with colorectal cancer, therefor, the detection of circulating tumor cells can be used to predict the survival prognosis of patients with colorectal cancer to improve patient's prognosis and survival rate.