摘要
目的探讨循环肿瘤细胞(CTCs)数目对神经母细胞瘤(NB)转移的诊断价值及疾病进展的预测价值。方法采用CD56免疫磁珠阳性分选和免疫荧光鉴定的方法,检测2015年11月—2017年3月我院收治的25例NB患儿CTCs,其中DAPI^+/GD2^+/CD45^-的细胞被认为是CTCs。结果治疗后发生肿瘤进展的患儿在初诊时NSE水平较高(P=0.010)、CTCs数目较多(P=0.015)、2个疗程化疗后CTCs检出率更高(P=0.028)。在4例骨髓NB细胞免疫表型流式检查阴性的患儿外周血中检测到CTCs,其中3人发生疾病进展并死亡。初诊时CTCs数目≥11个/3mL的患儿中位无进展生存时间较短(19.4个月vs.32.5个月,P=0.007)。结论初诊时NB患儿CTCs数目对于肿瘤转移早期诊断、疾病进展具有预测价值。对于骨髓流式检测阴性的患儿,外周血CTCs动态检测可作为监测NB进展的辅助手段。
Objective To explore the predictive value of circulating tumor cells(CTCs)for metastasis and progression in children with neuroblastoma(NB).Methods A total of 25 patients from Xinhua Hospital were included from November 2015 to March 2017.By use of immunomagnetic beads-based cell enrichment kit,we counted the number of DAPI^+/GD2^+/CD45^-cells in 3mL peripheral blood under fluorescence microscopy.Results Children with progressive disease had higher NSE levels(P=0.010),more CTCs number(P=0.015)and higher detectable rate of CTCs after 2 courses of chemotherapy(P=0.028).CTCs were detected in 4 children whose FACs tests of bone marrow were negative,and 3 of them had developed disease progression and died.Patients with more than 11 CTCs per 3 mL had worse progression-free survival(32.5 vs.19.4 months,P=0.007).Conclusions The level of CTCs is a sensitive indicator for metastasis at the time of initial diagnosis and has clinical value of prognostic evaluation.For children with negative FACS test,peripheral blood CTCs can be used as an adjunct method to monitor NB progression.
作者
杜诗蓓
金倩涯
马潇
魏蒙
袁晓军
DU Shibei;JIN Qianya;MA Xiao;WEI Meng;YUAN Xiaojun(Department of Pediatric Hematology/Oncology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)
出处
《中国小儿血液与肿瘤杂志》
CAS
2019年第5期258-262,共5页
Journal of China Pediatric Blood and Cancer
基金
上海市科学技术委员会医学引导课题(16411962500)
上海交通大学医学院转化医学创新项目(15ZH2005)
关键词
循环肿瘤细胞
神经母细胞瘤
转移
进展
Circulating tumor cells
Neuroblastoma
Metastasis
Tumor progression
