鼻咽癌患者外周血循环肿瘤细胞的检测及其与预后的相关性

目的:利用抗体标记和流式细胞仪联合方法检测鼻咽癌外周血中的循环肿瘤细胞(circulating tumor cells,CTCs)数量,分析评价CTCs与患者临床特征和预后之间的相关性.方法:针对福建省肿瘤医院2012年7月至2014年5月收治的67例鼻咽癌首诊患者以及10例健康志愿者,抽取外周血10ml,提取其中的单个核细胞.依次应用抗Epcam、抗CD45以及抗CK单克隆抗体对上述提取的单个核细胞进行抗体标记,将Epcam阳性、CD45阴性以及CK阳性的细胞作为鼻咽癌患者的CTCs,应用流式细胞仪检测其在外周血中的存在情况,分析其与患者临床特征及预后之间的关系.结果:鼻咽癌组外周血中的CTCs明显高于健康志愿者组,差异具有统计学意义(P<0.05).单因素分析结果表明,鼻咽癌患者外周血CTCs水平与进展情况(P=0.04)、N分期(P=0.001)以及临床分期(P=0.035)均显著相关.Logistic多因素回归分析结果则显示,仅患者的N分期与CTCs水平具有相关性(P=0.003),CTCs阳性患者的N分期更晚.Kaplan-Meier生存分析显示,CTCs阳性患者的无进展生存期(progression free survival,PFS)要显著短于CTCs阴性患者(P=0.029).结论:鼻咽癌患者外周血中CTCs阳性与患者N分期相关,且提示预后不良,可能成为鼻咽癌患者预后评估的一个辅助指标.

Detection of circulating tumor cells in peripheral blood of patients with nasopharyngeal carcinoma and evaluate its prognostic value

Objective:To analyze the relationship between circulating tumor cells (CTCs)of peripheral bloods by monoclonal antibody combined with flow cytometry in nasopharyngeal carcinoma (NPC)patients and clinicopathologi-cal characteristics,and evaluate its prognosis value. Methods:A total of 67 pathological confirmed nasopharyngeal carcinoma patients from July 2012 to May 2014 and 10 healthy volunteers were enrolled in this study. Peripheral blood mononuclear cells were extracted from patients'peripheral bloods,and anti - CD45 monoclonal antibody,anti - Epcam monoclonal antibody and anti - CK monoclonal anti - body were used to label the sample. Cells labelled CD45 - / Ep-cam + / CK + were considered as the CTCs. The presence of CTCs were measured by flow cytometry. The correlation be-tween CTCs and clinicopathological characteristics,and its prognosis value were analyzed. Results:CTCs were detec-ted in 40 of the NPC patients,none of CTCs were detected in healthy volunteers (P < 0. 05). Clinical staging,N stag-ing and progression status were found to be significantly associated with positive CTCs in peripheral blood of NPC pa-tients on univariate analysis (P < 0. 05,respectively). The Binary logistic regression analysis showed that only N stag-ing was associated with positive CTCs in peripheral blood of NPC patients (P = 0. 003). Kaplan - Meier survival anal-ysis indicated that patients with positive CTCs showed significantly shorter progression free survival (P = 0. 029). Conclusion:Positive CTCs in the peripheral bloods were associated with N staging and indicated a poor prognosis in NPC patients,and it might be served as an assistant indicators for early diagnosis and monitoring the prognosis of NPC.