摘要
目的:分析循环肿瘤细胞(circulating tumor cell,CTC)及其分型和肝细胞癌(hepatocellular carcinoma,HCC)分期、中医证型之间的相关性,并探讨CTC在HCC生存预后方面的应用价值。方法:选取2019年1月至2020年12月在河南中医药大学第一附属医院就诊的原发性肝癌患者75例,运用CanPatrolTM系统富集和鉴定患者外周静脉血CTC的分型计数;同时进行中医辨证分型、记录临床客观指标,并延伸随访2年;通过统计分析和ROC曲线对其量化分析,探讨CTC与HCC的中医证型与分期的关系,评价其预测肝癌预后的意义。结果:(1)不同中医证型间CTC总计数、上皮型CTC、混合型CTC和间质型CTC存在统计学差异(P<0.05),其中CTC总计数、混合型CTC与晚期肝癌中医证型关系更密切。(2)CTC总计数、混合型CTC分别与肝癌分期呈显著正相关(P<0.05)。(3)Ⅰb~Ⅱ期患者CTC总计数与2年生存率、中位无进展生存期(median progression-free survival,mPFS)呈负相关;Ⅲ期肝癌患者CTC总计数阳性与阴性患者在中位总生存期(median overall survival,mOS)、mPFS方面有显著差异(P<0.05),生存曲线(Kaplan-Meier)分析具有统计学意义(P<0.05),且COX回归分析显示,CTC总计数是Ⅰb~Ⅱ期肝癌患者死亡的独立危险因素(P<0.05)。结论:CTC总计数及其分型与原发性肝癌的中医辨证分型存在内在联系,可以作为原发性肝癌中医辨证分型的客观参考指标;CTC总计数及分型与肝癌分期具有相关性,提示其对肝癌疾病严重程度及预后有预警意义;CTC总计数高于阳性截断值时肝癌患者的生存率、mOS、mPFS均显著低于阴性患者。
Objective:To analyze the correlation between circulating tumor cell(CTC)and their types and the staging and TCM syndrome types of hepato cellular carcinoma(HCC),and to explore the application value of CTC in the survival and prognosis of HCC.Methods:From January 2019 to December 2020,75 patients with primary liver cancer in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were selected,and the CTCs typing count of patients'peripheral venous blood was enriched and identified by CanPatrolTM system.At the same time,TCM syndrome differentiation and classification were carried out,clinical objective indexes were recorded,and the follow-up was extended for 2 years;Through statistical analysis and ROC curve quantitative analysis,this paper discusses the relationship between TCM syndrome types and staging of CTCs and HCC,and evaluates its significance in predicting the prognosis of liver cancer.Results:(1)There were statistical differences among different TCM syndromes(P<0.05),including the total number of CTCs,epithelial CTCs,mixed CTCs and interstitial CTCs,among which the total number of CTCs and mixed CTCs were more closely related to the nh type of TCM syndrome of advanced liver cancer.(2)The total number of CTCs and mixed CTCs were positively correlated with the staging of HCC(P<0.05).(3)The total CTCs count of IB-II patients was negatively correlated with 2-year survival rate and medianprogression-freesurvival(mPFS).There were significant differences in medianoverallsurvival(mOS)and mPFS between patients with positive CTCs total count and patients with negative CTCs total count.Kaplan-Meier analysis was statistically significant,and COX regression analysis showed that CTCs total count was an independent risk factor for the death of patients with Ib-II liver cancer(P<0.05).Conclusion:CTC total count and its classification are intrinsically related to TCM syndrome differentiation and classification of primary liver cancer,which can be used as an objective reference index for TCM synd
作者
朱帅帅
邝玉慧
陈晓琦
赵强
袁长威
张传雷
王新亭
陈欣菊
ZHU Shuaishuai;KUANG Yuhui;CHEN Xiaoqi;ZHAO Qiang;YUAN Changwei;ZHANG Chuanlei;WANG Xinting;CHEN Xinju(The First Clinical Medical College to Henan University of Chinese Medicine,Zhengzhou Henan China 450046;Tianjin University of Chinese Medicine,Tianjin China 301617;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)
出处
《中医学报》
CAS
2023年第10期2192-2200,共9页
Acta Chinese Medicine
基金
国家科技重大专项资助项目(2018ZX10303502-001)
河南省特色骨干学科中医学学科建设项目(STG-ZYX01-20210)
河南省中医药科学研究专项课题项目(2022JDZX018)。
关键词
肝细胞癌
循环肿瘤细胞
肿瘤分期
中医证型
肝癌预后指标
hepato cellular carcinoma
circulating tumor cell
tumor staging
TCM syndrome type
prognostic index of liver cancer
