摘要
目的探讨微创食管癌切除术(MIE)和开放食管癌切除术(OE)对食管癌患者围术期外周血循环肿瘤细胞(CTCs)动态变化的影响。方法选取2015年10月~2017年10月期间收治的73例食管癌患者并随机分为MIE组(38例)和OE组(35例),同时以10例食管良性疾病者和10例健康志愿者为对照组。采用Can PatrolTMCTCs检测技术检测两组食管癌患者及对照组外周血液中CTCs数量的分布情况。结果(1)在73例食管癌患者中,术前CTCs检测44例(60.3%)为阳性,对照组均为阴性;(2)73例食管癌患者术中外周血CTCs水平高于术前,术后CTCs水平高于术中,差异均有统计学意义(P<0.001);(3)MIE组和OE组患者术前及术中外周血CTCs水平比较差异无统计学意义(P>0.05),但MIE组术后外周血CTCs水平显著低于OE组,且从术前至术后CTCs增幅水平在MIE组显著低于OE组,差异有统计学意义(P<0.001);(4)MIE组术后(2周)总并发症发生率为28.9%(11/38),明显低于OE组的54.3%(19/35),差异有统计学意义(P=0.023),而且在MIE组和OE组均有并发症的患者中CTCs水平明显高于无并发症的患者(P=0.001;P=0.005)。结论 MIE有助于降低术后早期外周血中因手术播散的CTCs数量,并且动态监测CTCs水平可用于评估患者的预后。CTCs可以成为监测食管癌患者预后一个较好的辅助指标。
Objective To investigate the effects of minimally invasive esophagectomy（MIE） and open esophagectomy（OE） on the level of circulating tumor cells（CTCs） in patients with esophageal cancer（EC）. Methods A total of 73 patients with EC undergoing MIE（n=38） or OE（n=35） in our department between October, 2015 and October, 2017 were enrolled, with 10 patients with benign esophagus disease and 10 healthy volunteers as controls. The levels of CTCs in the peripheral blood of the participants were detected using Can PatrolTMtechnique and analyzed for their association with the operation methods and perioperative complications. Results CTCs were detected in 60.3%（44/73） of the EC patients but in none of the control subjects.CTC level after the surgery was significantly higher than that during the surgery, and CTC level during the surgery was significantly higher than that before surgery（P〈0.001）. The preoperative and intra-operative CTC levels were not significantly different between MIE and OE groups（P〈0.05）, but the postoperative CTC level was significantly lower in MIE group than in OE group, and postoperative increment of CTC level（from the preoperative level） was significantly lower in MIE group than in OE group（P〈0.001）. The total incidence of postoperative complications was significantly lower in MIE group than in OE group（28.9% vs 54.3%, P=0.023）, and in both groups, CTC levels in patients with complications were significantly higher than those in patients without complications（P=0.001 and P=0.005 in MIE and OE groups, respectively）. Conclusion MIE may help to reduce the number of peripheral blood CTCs early after the operation, and dynamic monitoring CTCs level assists in evaluation of the prognosis of EC patients. CTC level may serve as an indicator for monitoring the prognosis of EC.
作者
郭鑫
吴源周
贾龙飞
李雅玲
闫玉生
陈群清
GUO Xin;WU Yuanzhou;JIA Longfei;LI Yaling;YAN Yusheng;CHEN Qunqing(Department of Cardiothoracic Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China)
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2018年第3期318-323,共6页
Journal of Southern Medical University
基金
广东省科技计划项目(2016ZC0085)
