外周血循环肿瘤细胞与肾癌病理指标及患者预后的关系(1)
[摘要] 目的 探究外周血循环肿瘤细胞(CTCs)与肾癌病理指标及患者预后的关系。 方法 将2014年2月～2017年12月湖北省十堰市太和医院收治的107例肾癌患者及查体的20例健康志愿者纳入研究，采用免疫磁珠富集及免疫荧光化学染色法进行外周血CTCs计数，分析CTCs阳性率与肾癌患者年龄、性别、临床分期、T分期、Fuhrman分级及中性粒细胞、血钙、血小板等临床指标的关系，并探究外周血CTCs与肾癌患者预后的关系。 结果 肾癌患者CTCs检出率为66.35%，健康志愿者外周血中未发现CTCs;CTCs阳性率与患者T分期、临床分期及中性粒细胞增多相关(P < 0.05)，Logistic回归分析提示患者T分期为独立危险因素(OR = 1.816，95%CI：0.814～4.052，P < 0.05);所有患者均进行随访，随访时间为60～627 d，CTCs阳性患者的中位生存时间短于CTCs阴性患者(P < 0.05)。 结论 外周血CTCs阳性检出率与肾癌患者T分期、临床分期及中性粒细胞增多相关，其中肿瘤T分期是外周血CTCs的独立危险因素，外周血CTCs可作为判断肾癌患者预后的辅助信息。
[关键词] 外周血循环肿瘤细胞;肾癌;病理指标;预后
[中图分类号] R737.11 [文献标识码] A [文章编号] 1673-7210(2019)01(b)-0085-04
[Abstract] Objective To explore the relationship between peripheral blood circulating tumor cells (CTCs) and pathological paramets， and prognosis of renal cancer. Methods One hundred and seven patients with renal cell carcinoma admitted to Taihe Hospital of Shiyan in Hubei Province， from February 2014 to December 2017 and 20 healthy volunteers who performed physical examination were enrolled in the study. The immunomagnetic enrichment and immunofluorescence staining methods were used to count peripheral blood CTCs. The relationship between the positive rate of CTCs and age， gender， clinical stage， T stage， Fuhrman grade， clinical parameters such as neutrophils， serum calcium and platelets were analyzed. The relationship between peripheral blood CTCs and the prognosis of renal cancer was explored. Results The detection rate of CTCs in patients with renal cancer was 66.35%. No CTCs were found in peripheral blood of healthy volunteers. The positive rate of CTCs was related to the T stage， clinical stage and increase of neutrophils (P < 0.05). Logistic regression analysis showed that T stage was an independent risk factor (OR = 1.816， 95%CI： 0.814-4.052， P < 0.05). All the patients were followed up for 60-627 d. The median survival time of CTCs positive patients was shorter than that of CTCs negative patients (P < 0.05). Conclusion The positive rate of CTCs in peripheral blood is related to T stage， clinical stage and increase of neutrophils in patients with renal cancer. The T stage of tumor is an independent risk factor for peripheral blood CTCs. Peripheral blood CTCs can be used as auxiliary information for judging the prognosis of patients with renal cancer.
[Key words] Peripheral blood circulating tumor cells; Renal cancer; Pathological index; Prognosis
腎癌是发病率仅次于膀胱癌的泌尿系统肿瘤，近年来有逐年上升的趋势[1]。外科治疗是肾癌主要治疗方式，但是约1/3患者在就诊时就已出现转移，且术后极易复发，晚期肾癌的预后效果不佳。因此临床上肾癌的早期诊断、控制及预防癌症转移、复发是目前肾癌治疗的重大课题之一[2-3]。循环肿瘤细胞(CTCs)是肿瘤原发或病灶播散于血液中的肿瘤细胞，可定植形成肿瘤转移病灶，研究显示CTCs数量与肿瘤的恶性程度、放化疗治疗反应等密切相关[4]。对外周血CTCs进行分析研究，可明确癌症转移过程，对辅助诊断、治疗效果监测及预后判断等方面均具有重要应用价值[5-6]。目前，乳腺癌、前列腺癌及结肠癌CTCs检测均被批准用于临床，而肾癌CTCs的临床应用尚待推进[7]。本研究对肾癌患者及健康志愿者外周血CTCs水平进行测定，联系肾癌患者各临床病理指标进行分析，探究外周血CTCs与肾癌预后的关系。现报道如下：, http://www.100md.com(李昊 陈从波 姚启盛 龚小芳)
[关键词] 外周血循环肿瘤细胞;肾癌;病理指标;预后
[中图分类号] R737.11 [文献标识码] A [文章编号] 1673-7210(2019)01(b)-0085-04
[Abstract] Objective To explore the relationship between peripheral blood circulating tumor cells (CTCs) and pathological paramets， and prognosis of renal cancer. Methods One hundred and seven patients with renal cell carcinoma admitted to Taihe Hospital of Shiyan in Hubei Province， from February 2014 to December 2017 and 20 healthy volunteers who performed physical examination were enrolled in the study. The immunomagnetic enrichment and immunofluorescence staining methods were used to count peripheral blood CTCs. The relationship between the positive rate of CTCs and age， gender， clinical stage， T stage， Fuhrman grade， clinical parameters such as neutrophils， serum calcium and platelets were analyzed. The relationship between peripheral blood CTCs and the prognosis of renal cancer was explored. Results The detection rate of CTCs in patients with renal cancer was 66.35%. No CTCs were found in peripheral blood of healthy volunteers. The positive rate of CTCs was related to the T stage， clinical stage and increase of neutrophils (P < 0.05). Logistic regression analysis showed that T stage was an independent risk factor (OR = 1.816， 95%CI： 0.814-4.052， P < 0.05). All the patients were followed up for 60-627 d. The median survival time of CTCs positive patients was shorter than that of CTCs negative patients (P < 0.05). Conclusion The positive rate of CTCs in peripheral blood is related to T stage， clinical stage and increase of neutrophils in patients with renal cancer. The T stage of tumor is an independent risk factor for peripheral blood CTCs. Peripheral blood CTCs can be used as auxiliary information for judging the prognosis of patients with renal cancer.
[Key words] Peripheral blood circulating tumor cells; Renal cancer; Pathological index; Prognosis
腎癌是发病率仅次于膀胱癌的泌尿系统肿瘤，近年来有逐年上升的趋势[1]。外科治疗是肾癌主要治疗方式，但是约1/3患者在就诊时就已出现转移，且术后极易复发，晚期肾癌的预后效果不佳。因此临床上肾癌的早期诊断、控制及预防癌症转移、复发是目前肾癌治疗的重大课题之一[2-3]。循环肿瘤细胞(CTCs)是肿瘤原发或病灶播散于血液中的肿瘤细胞，可定植形成肿瘤转移病灶，研究显示CTCs数量与肿瘤的恶性程度、放化疗治疗反应等密切相关[4]。对外周血CTCs进行分析研究，可明确癌症转移过程，对辅助诊断、治疗效果监测及预后判断等方面均具有重要应用价值[5-6]。目前，乳腺癌、前列腺癌及结肠癌CTCs检测均被批准用于临床，而肾癌CTCs的临床应用尚待推进[7]。本研究对肾癌患者及健康志愿者外周血CTCs水平进行测定，联系肾癌患者各临床病理指标进行分析，探究外周血CTCs与肾癌预后的关系。现报道如下：, http://www.100md.com(李昊 陈从波 姚启盛 龚小芳)