摘要
目的探讨循环肿瘤细胞(circulating tumor cell,CTC)形态学分析与老年非小细胞肺癌患者临床资料的相关性,评价CTC形态学分析在老年非小细胞肺癌患者预后判断中的作用。方法收集2017年1月-2019年12月在本科术前CTC检测阳性的108例70岁及以上老年非小细胞肺癌患者的临床资料,将CTC进行计数,并根据其形态学将捕获CTC分为大细胞CTC组与小细胞CTC组,与临床病理资料进行结合分析。以总生存率(OS)及无病生存率(DFS)作为评价指标,Kaplan-Meier法分析两组患者的预后,Cox法行生存因素的分析。结果全组共108例,中位CTC捕获数4个,其中大细胞CTC组52例,小细胞CTC组56例,中位随访时间为22个月。大细胞CTC组mOS为29.3月,OS为61.5%,DFS为59.6%;小细胞CTC组mOS为20.8个月,OS为54.2%,DFS为53.4%,小细胞CTC组OS及RFS均低于大细胞CTC组(P<0.05)。单因素及多因素生存分析提示:TNM分期、淋巴结转移、小细胞型CTC可能为影响老年非小细胞肺癌患者预后的不良因素。结论小细胞型CTC与非小细胞肺癌的进展相关,可能是老年非小细胞肺癌患者预后的不良的因素。
Objective To explore the correlation between circulating tumor cell(CTC)morphological analysis and clinical data of elderly patientswith non-small cell lung cancer(NSCLC),and to evaluate the role of CTCmorphological analysis in prognostic judgment of elderly patients with NSCLC.Methods The clinical data of 108 elderly patients with NSCLC aged 70 years and above who were positive for CTC test before surgery in our department from January 2017 to December 2019 were collected.Their CTC was counted and then they were divide into large-cell CTC group and small-cell CTC group according to CTC morphology.Their clinical and pathological data were analyzed.The overall survival rate(OS)and disease-free survival rate(DFS)were used as evaluation indexes,the prognosis of the two groupswas analyzed byKaplanMeiermethod,and the survival factors were analyzed by Cox method.Results The median number of CTC was 4 in 108 cases,including 52 cases in large-cell CTC group and 56 cases in small-cell CTC group.The median follow-up time was 22 months.The mOS of the large-cell CTC group was 29.3 months,the OS was 61.5%,and the DFS was 59.6%;the mOS of the small-cell CTC group was 20.8 months,the OS was 54.2%,and the DFS was 53.4%.The OS and RFS of the small-cell CTC group were lower than those of the largecell CTC group(P<0.05).Univariate and multivariate survival analysis showed that TNM stage,lymph node metastasis and small cell CTC may be the adverse factors affecting the prognosis of elderly patients with NSCL.Conclusion Small cell CTC is associated with the progression of NSCLC and may be a poor prognostic factor in elderly patients with NSCLC.
作者
武韫
吕帆真
吴越
牛玉旭
高文
Wu Yun;Lyu Fanzhen;Wu Yue;Niu Yuxu;Gao Wen(Department of Thoracic Surgery,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)
出处
《老年医学与保健》
CAS
2020年第4期640-643,共4页
Geriatrics & Health Care
基金
上海申康医院发展中心临床科技创新项目(SHDC12018113)
上海市市级医院临床研究培育项目(SHDC12019X11)。
关键词
非小细胞肺癌
循环肿瘤细胞形态学
老年
预后
non-small cell lung cancer
circulating tumor cell morphology
elderly
prognosis
