中国肿瘤外科杂志2024，Vol.16Issue(3)：234-241,8.DOI:10.3969/j.issn.1674-4136.2024.03.005
胃癌循环肿瘤细胞与临床病理特征及预后的相关性研究
Correlation study of circulating tumor cells in gastric cancer with clinicopathologic features and prognosis
摘要
Abstract
Objective To explore the correlations between circulating tumor cells(CTCs)and its subtypes with clinicopathological features and prognosis in gastric cancer patients.A prospective study method was adopted to randomly select initial treatment patients with gastric adenocarcinoma who were pathologically diagnosed and qualified for enrollment at the Department of Gastrointestinal Surgery,Guangxi Medical University Cancer Hospital from May 2015 to January 2019 as the study objects.CanpatrolTM system was used to isolate and purify CTCs from samples of pre-surgical peripheral blood and in situ mRNA hybridization was used for typing,enumeration and identification of CTCs.The correlation between CTCs and their subtypes and age,gender,degree of differentiation,nerve invasion,vascular invasion,Lauren classification,tumor location,depth of invasion(T stage),lymph node metastasis(N stage)and pathological stage of AJCC was analyzed.All enrolled cases were followed up to analyze the correlation between CTCs and prognosis.Results Fifty-eight patients(21 females and 37 males)of mean age 54.4 years were enrolled in this study.The phenotype of CTCs was determined as epithelial-(eCTCs),mix-(mixCTCs)or mesenchymal-(mCTCs)type based on CanpatrolTM system.Overall detection rate of CTCs was 90.7％,and among these,the eCTCs detection rate was 68.5％,the mixCTCs detection rate was 74.1％and the mCTCs detection rate was 61.1％;The number of CTCs and their subtypes were correlated with Lauren type and age;Total number of CTCs and mixCTCs in preoperative peripheral blood of gastric cancer cases aged＜60 years were significantly lower than those of cases aged ≥60(P=0.016).According to Lauren type,total CTCs count,eCTCs count and mCTCs count were significantly higher in Intestinal-type than in diffuse type gastric cancer.There was no significant relationship between pathologic stage with CTCs and its subtypes count.However,when stratified by Lauren type,significant positive correlations was founded between eCTCs count and the pathologic stage in Intestinal-type gastric cancer(P＜0.05).There was no significant association between CTCs count with age,gender,nerve invasion,vascular invasion,tumor site,tumor invasion(T)and lymph node metastasis(N).The mean follow-up time of this patients in the group was 50 months,which did not reach the median overall survival time.Further multivariate Cox regression analyses revealed that TNM stage,Lauren type and nerve invasion are independent prognosis predictors of gastric cancer.The number of CTCs revealed no correlation with the prognosis.Conclusions Different subtype of Epithelial and Mesenchymal markers were detected in the CTCs,which indicated that EMT occurred in peripheral blood CTCs of patients with gastric cancer.The number of CTCs and its subtypes were significantly correlated with Lauren type,the number of CTCs detected in intestinal type are closely related to pathological stage,suggesting that the detection of CTCs may have more application value in monitoring the prognosis of Lauren Intestinal-type gastric cancer.关键词
胃癌/循环肿瘤细胞/上皮-间质转化/Lauren分型Key words
Gastric Cancer/Circulating Tumor Cells/Epithelial-mesenchymal transition/Lauren type引用本文复制引用
潘佳宇,黄名威,梁榜辉,吴留成,王婷安,韦尉元,金钦文,宋经清,韦朝联,覃宇周..胃癌循环肿瘤细胞与临床病理特征及预后的相关性研究[J].中国肿瘤外科杂志,2024,16(3):234-241,8.基金项目
国家自然科学基金项目(81760521,82360593) （81760521,82360593）
广西自然科学基金项目(2023GXNSFAA026133,2024GXNSFAA010407) （2023GXNSFAA026133,2024GXNSFAA010407）
