不同分期结直肠癌患者循环肿瘤细胞的表达及临床意义

目的探讨不同分期结直肠癌患者外周血循环肿瘤细胞的表达及其临床意义.方法对76例结直肠癌患者(病例组)和50名健康体检者(对照组)使用免疫磁捕获、免疫细胞化学鉴定法检测循环肿瘤细胞的表达,采用电化学发光法检测患者的癌胚抗原、糖类癌抗原242、糖类癌抗原19-9、糖类癌抗原50、糖类癌抗原125.比较两组被试循环肿瘤细胞的表达,以及不同分期直肠癌患者循环肿瘤细胞阳性检出率,分析患者循环肿瘤细胞表达与肿瘤标志物的相关性,随访统计患者总体生存期.结果病例组循环肿瘤细胞数目≥1检出率为76.32%,明显高于对照组的10.71%,差异有统计学意义(P<0.01).病例组循环肿瘤细胞数目≥2、≥5检出率分别为65.79%、35.53%,对照组均未检出,两组比较差异有统计学意义(P<0.01).不同T分期和N分期患者循环肿瘤细胞阳性率比较,差异均无统计学意义(P>0.05).M1分期患者循环肿瘤细胞阳性率为85.71%,明显高于M0分期患者的58.18%,差异有统计学意义(P<0.05).不同肿瘤分期患者的循环肿瘤细胞阳性率比较差异有统计学意义(P<0.05),Ⅳ期最高(85.71%),Ⅲ期次之(65.00%),Ⅱ期最低(40.00%).循环肿瘤细胞水平与肿瘤标志物癌胚抗原、糖类癌抗原242和糖类癌抗原19-9阳性呈显著正相关(P<0.01),与糖类癌抗原50和糖类癌抗原125无明显相关性(P>0.05).循环肿瘤细胞阳性患者总体生存时间明显短于阴性患者(P<0.05).结论结直肠癌患者循环肿瘤细胞表达明显高于正常人群,与肿瘤标志物癌胚抗原、糖类癌抗原242和糖类癌抗原19-9表达具有相关性;临床分期越高,循环肿瘤细胞阳性率越高,患者生存时间越短,循环肿瘤细胞可作为判断患者预后的指标.

Expression and clinical significance of CTC in patients with different stages of colorectal cancer

Objective To detect the expression and clinical significance of CTC in patients with different stages of colorectal cancer.Methods 76 patients with colorectal cancer(case group)and 50 health subjects(control group)were selected.The expression level of CTC was detected by immunomagnetic capture and immunocytochemical identification,and the carcinoembryonic antigen(CEA),carbohydrate antigen CA242,CA19-9,CA50 and CA125 were detected by electrochemiluminescence.The CTC expression level in the two groups and the CTC positive detection rate of patients with different stages were compared.The correlation between CTC level and tumor markers was analyzed,and the overall survival time of patients was followed.Results The detection rate of CTC≥1 in case group was significantly higher than that in control group(76.32%vs 10.71%)(P<0.01).The detection rates of CTC≥2 and 5 in case group were 65.79%and 35.53%respectively,and none was detected in control group,and there was a significant difference between the two groups(P<0.01).There was no significant difference in the positive rate of CTC between patients with different T and N stages(P>0.05).The positive rate of CTC in M1 stage patients was significantly higher than that in M0 stage patients(85.71%vs 58.18%)(P<0.05).The positive(40.00%)(P<0.05).The CTC level was significantly positively correlated with tumor markers CEA,CA242 and CA19-9(P<0.01),and was not significantly correlated with CA50 and CA125(P>0.05).The overall survival time of CTC-positive patients was significantly shorter than that of CTC-negative patients(P<0.05).Conclusions The expression level of CTC in colorectal cancer patients is significantly higher than that in normal population,and it is associated with tumor markers CEA,CA242 and CA19-9.The higher the clinical stages,the higher the positive rate of CTC and the shorter the survival time of patients.CTC can be used as an indicator to judge the prognosis of patients.