转化医学杂志2025，Vol.14Issue(7)：95-100,6.DOI:10.3639/j.issn.2095-3097.2025.07.018
叶酸受体阳性循环肿瘤细胞对结直肠癌根治术患者预后的预测价值
Prognostic Value of Folate Receptor-positive Circulating Tumor Cells in Patients with Radical Resection of Colorectal Cancer
摘要
Abstract
Objective To analyze the prognostic value of folate receptor-positive circulating tumor cells(FR+-CTCs)in colorectal cancer(CRC)patients undergoing radical resection.Methods A retrospective analysis was conducted on 142 CRC patients who underwent radical resection at Meizhou People's Hospital from March 2021 to October 2022.The patients were classified into a disease-free group(n=98)and a progression group(n=44).General clinical data and preoperative FR+-CTCs levels were compared between groups.Cox regression analysis was used to identify independent risk factors affecting CRC prognosis,and a nomogram prediction model was constructed.The model's value was assessed.Based on the optimal cut-off value of preoperative FR+-CTCs levels,the 142 patients were divided into a high-level group(n=52)and a low-level group(n=90).Disease-free survival(DFS)was compared between these groups.Results Age,maximum tumor diameter,preoperative FR+-CTCs levels,proportion of Dukes C1 stage,and proportion of poor differentiation were significantly higher in the progression group than in the disease-free group(P<0.05).Multivariate Cox regression showed that age,maximum tumor diameter,Dukes stage,differentiation degree,and preoperative FR+-CTCs level were independent risk factors for CRC prognosis(P<0.05).The constructed nomogram model had an area under the curve(AUC)of 0.95 in both the training and validation sets.Hosmer-Lemeshow goodness-of-fit test showed χ2=3.164(P=0.924)for the validation set.Decision curve analysis indicated better clinical net benefit when the validation set threshold probability was 0.02-0.96.At follow-up until November 2024,the high-level group had significantly shorter DFS than the low-level group(P<0.05).Conclusion FR+-CTCs is an independent risk factor affecting CRC prognosis.The nomogram combining FR+-CTCs with traditional clinicopathological factors provides a practical tool for DFS prediction,which is expected to optimize individualized treatment strategies for CRC.关键词
叶酸受体阳性循环肿瘤细胞/结直肠癌根治术/预后/列线图/无病生存期Key words
Folate receptor-positive circulating tumor cells/Radical resection for colorectal cancer/Prognosis/nomogram/Disease-free survival分类
医药卫生引用本文复制引用
张日雄,吴祖光,刘凡,陈文局,刘宏涛,饶辉,李运霖..叶酸受体阳性循环肿瘤细胞对结直肠癌根治术患者预后的预测价值[J].转化医学杂志,2025,14(7):95-100,6.基金项目
广东省中医药局科研项目(20241325) （20241325）
梅州市科技计划项目(211130092050186) （211130092050186）
