| 王 珂,岳育民,许泽宇,等.循环肿瘤细胞在局部进展期结直肠癌术后早期复发监测中的意义[J].肿瘤学杂志,2025,31(8):671-677. |
| 循环肿瘤细胞在局部进展期结直肠癌术后早期复发监测中的意义 |
| Detection of Circulating Tumor Cells for Monitoring of Early Postoperative Recurrence in Patients with Locally Advanced Colorectal Cancer |
| 投稿时间：2024-09-26 |
| DOI：10.11735/j.issn.1671-170X.2025.08.B004 |
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| 中文关键词: CytoSorter系统 循环肿瘤细胞 结直肠肿瘤 局部进展期 复发 无复发生存 |
| 英文关键词:CytoSortersystem circulating tumor cells colorectal neoplasms locally advanced recurrence progression?鄄free survival |
| 基金项目:陕西省重点研发计划项目（S2020-YF-YBSF-0777） |
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| 中文摘要: |
| 摘 要： ［目的］ 探讨利用CytoSorter?誖捕获系统检测循环肿瘤细胞（circulating tumor cells，CTCs）的可行性，并评估CTCs作为局部进展期结直肠癌（locally advanced colorectal cancer，LACRC）术后早期复发生物标志物的可能性。［方法］ 2018年1月至2020年2月西安国际医学中心医院144例LACRC患者纳入研究，术前通过CytoSorter?誖富集外周血中的CTCs。术后根据患者复发状态，将患者分为复发组（n=53例）和未复发组（n=91例），分析CTCs计数与患者临床病理特征及复发的相关性。［结果］ 全组患者中术前CTCs中位计数为2.0（0.0~4.0）个/mL。CTCs阳性检出率为68.06%（98/144），显著高于CEA阳性率［50.69%（73/144）］（χ2=8.997，P=0.003）。cTNM分期Ⅲ期、未进行腹腔镜手术、疾病复发的患者CTCs数量和CTCs阳性率显著高于cTNM分期Ⅱ期、进行腹腔镜手术、疾病未复发的患者（P均＜0.05）。与术前CTCs＜2个/mL患者相比，术前CTCs≥2个/mL患者的无复发生存期显著降低（HR=2.761，95%CI：1.516~5.027，P=0.001）。单变量分析显示，术前CTCs检出率、术后病理分期、淋巴血管侵犯、神经侵犯与术后复发显著相关（P均＜0.05）。多因素分析显示，淋巴血管侵犯（HR=2.718，95%CI：1.458~5.068，P=0.002）、神经侵犯（HR=2.130，95%CI：1.174~3.865，P=0.013）和CTCs≥2个/mL（HR=3.136，95%CI：1.458~6.743，P=0.003）是LACRC患者术后复发的独立危险因素。［结论］ 术后复发的LACRC患者其术前CTCs计数更高，术前CTCs可作为LACRC患者术后复发的监测工具，可用于LACRC患者术后管理的风险分层和决策。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the feasibility of CytoSorter?誖capture system to detect circulating tumor cells (CTCs) and to evaluate the potential of CTCs for monitoring of early postoperative recurrence in patients with locally advanced colorectal cancer(LACRC). ［Methods］ A total of 144 patients with LACRC undergoing radical resection in Xi’an International Medical Center Hospital from January 2018 to February 2020 were enrolled in the study. There were 53 patients having postoperative recurrence (recurrent group) and 91 patients without recurrence group (non-recurrence) . The CTCs in peripheral blood were enriched by CytoSorter?誖prior to surgery， and the relationship of CTCs count with clinicopathological characteristics and recurrence was analyzed. ［Results］ The median preoperative CTCs count in all patients was 2.0 (0.0~4.0) cells/mL. The positive detection rate of CTCs was significantly higher than that of CEA ［68.06% (98/144) vs 50.69% (73/144) ， χ2=8.997， P=0.003］. The number and positive rate of CTCs in patients with cTNM stage Ⅲ， non laparoscopic surgery， and disease recurrence were significantly higher than those with cTNM stage Ⅱ， undergoing laparoscopic surgery， and having no disease recurrence (all P<0.05). Compared with patients with preoperative CTCs <2 cells/mL， the progression-free survival (PFS) of patients with preoperative CTCs≥2 cells/mL was lower (HR=2.761， 95%CI：1.516~5.027， P=0.001). Multivariate analysis showed that lymphovascular invasion (HR=2.718， 95%CI： 1.458~5.068， P=0.002)， nerve invasion (HR=2.130， 95%CI： 1.174~3.865， P=0.013)， and CTCs ≥2 cells/mL (HR=3.136， 95%CI： 1.458~6.743， P=0.003) were independent risk factors for postoperative recurrence in LACRC patients. ［Conclusion］ Preoperative CTCs count is higher in LACRC patients with postoperative recurrence， which indicates that preoperative CTCs count may be used as a monitoring tool for postoperative recurrence in LACRC patients，and for risk stratification and decision-making in the postoperative management. |
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