摘要
目的探讨循环肿瘤细胞（CTC）计数在辅助诊断结直肠癌中的应用价值。方法收集2015年7月至10月就诊的61例初治结直肠癌患者，病理分期为Ⅰ期至Ⅳ期，另选取同期健康志愿者或结直肠良性疾病患者20例为对照，于治疗前采集外周静脉血7.5 mL，2 h内以免疫磁珠富集联合荧光染色法计数外周血CTC，分析CTC对结直肠癌尤其是早期结直肠癌的阳性检出率，以及与CEA联合应用的优势。采用卡方检验、t检验和秩和检验进行统计学分析。结果有2例结直肠癌患者因未进行全身影像学评估，无法进行病理分期，结直肠癌组早期（Ⅰ期至Ⅱ期）患者30例，晚期（Ⅲ期至Ⅳ期）患者29例。早期和晚期CEA水平比较[（3.3±1.1） μg/L比（20.4±3.3） μg/L ]，差异有统计学意义（t＝－2.74，P＝0.008）。结直肠癌组和对照组CTC的中位计数（四分位数间距）分别为1个（4个）和0个，差异有统计学意义（Z＝2.721，P＝0.007）。以0个/7.5 mL和5 μg/L分别作为CTC和CEA定量的截断值，CTC对结直肠癌和早期结直肠癌的检出率分别为65.6%（40/61）和63.3%（19/30），CEA对结直肠癌和早期结直肠癌的检出率分别为29.5%（18/61）和13.3%（4/30），若CTC和CEA联合应用，则对结直肠癌和早期结直肠癌的检出率分别提高至73.8%（45/61）和66.7%（20/30）。结论CTC计数对结直肠癌尤其是早期结直肠癌的检出具有一定的价值，其与CEA联合应用，检出率可进一步提高。
Objective To explore the application value of circulating tumor cell （CTC） counting in the diagnosis of patients with colorectal cancer. Methods From July to October in 2015, a total of 61 patients firstly diagnosed with colorectal cancer, at stage I to rq were enrolled. At the same period, 20 individuals （healthy volunteers or patients with benign eolorectal diseases） were selected as controls. Peripheral blood （7.5 mL） was taken before therapy. Peripheral blood CTC were counted by immunomagnetic beads enrichment combined with fluorescent staining method in two hours. The positive detection rate of CTC for colorectal cancer, especially early colorectal cancer was analyzed. And the priority of combination it with carcino-embryonic antigen （CEA） was also investigated. Chi-square test, t test and rank-sum test were used for statistical analysis. Results Two patients could not be pathological staged, due to the lack of whole body imaging evaluation. There were 30 patients with colorectal cancer at early stage （stage I to II ） and 29 patients at advanced stage （stage Ill to IV）. The difference in CEA level between patients at early stage and advanced stage （（3.3±1.1） μg/L vs （20.4±3.3） μg/L） was statistically significant （t= -2.74, P= 0. 008）. The median cell number of CTC of colorectal cancer group and control group was 1 （interquartile range=4） and 0, respectively, and the difference was statistically significant （Z=2. 721, P=0. 007）. Taken 0/7.5 mL and 5 μg/L as the cut-off value of CTC and CEA, the detection rates of CTC for colorectal cancer and early coloreetal cancer were 65. 6% （40/61） and 63. 3% （19/30）, respectively; the detection rates of CEA for colorectal cancer and early colorectal cancer were 29.5% （18/ 61） and 13.3%（4/30）. When CTC combined with CEA, the detection rates for colorectal cancer and early colorectal cancer were 73.8% （45/61） and 66.7% （20/30）, respectively. Conclusions CTC has certain detection value in colorecta
出处
《中华消化杂志》
CAS
CSCD
北大核心
2017年第10期679-683,共5页
Chinese Journal of Digestion
关键词
结直肠肿瘤
循环肿瘤细胞
诊断
Colorectal neoplasms
Circulating tumor cell
Diagnosis
