本文選題：CTCs + 膀胱癌��； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]檢測(cè)非肌層浸潤性膀胱癌(Non muscle-invasive bladder cancer,NMIBC)患者與肌層浸潤性膀胱癌(muscle-invasive bladder cancer,MIBC)患者外周血循環(huán)腫瘤細(xì)胞(Circulating tumor cells,CTCs)的計(jì)數(shù)及分型,探討其在膀胱癌TNM分期及預(yù)后評(píng)估中的臨床應(yīng)用價(jià)值。[方法]對(duì)符合入組條件,在昆明醫(yī)科大學(xué)第二附屬醫(yī)院泌尿外科接受腹腔鏡下根治性膀胱切除術(shù)或經(jīng)尿道膀胱腫瘤電切術(shù)的41例膀胱腫瘤患者,采用CanPatrolTM二代CTCs檢測(cè)技術(shù),檢測(cè)外周血中的CTCs�；颊吣挲g33歲—83歲,男性患者37例,女性患者4例。腫瘤TNM分期為:T1期15例;T2期12例;T3期9例;T4期5例;N1期6例;M1期3例。腫瘤病理組織分級(jí)為:高級(jí)別膀胱癌30例;低級(jí)別膀胱癌11例。[結(jié)果]41例膀胱癌患者總CTCs陽性率68.29%(28/41),6例淋巴結(jié)轉(zhuǎn)移患者中檢出CTCs陽性2例,3例遠(yuǎn)處轉(zhuǎn)移患者中檢出CTCs陽性1例。30例高級(jí)別膀胱癌中CTCs檢出20例,占66.7%,11例低級(jí)別膀胱癌中CTCs檢出7例,占63.6%。13例CTCs陰性患者中,無淋巴結(jié)轉(zhuǎn)移10例(69.23%),淋巴結(jié)轉(zhuǎn)移3例(30.76%)。非肌層浸潤性膀胱癌高風(fēng)險(xiǎn)(G3)患者中,間質(zhì)型CTCs陽性率為60%,CTCs總數(shù)≥3的患者陽性率為:60%;非肌層浸潤性膀胱癌中風(fēng)險(xiǎn)(G2)患者中,間質(zhì)型CTCs陽性率為20%,CTCs總數(shù)3的患者陽性率為:20%。29例患者術(shù)后隨訪12~41月,平均14±2月,死亡8例。術(shù)后總生存率72.41%,其中 CTCs 陽性生存率 77.77%(14/18),CTCs 陰性生存率 63.6%(7/11)。[結(jié)論]1、非肌層浸潤性膀胱癌高風(fēng)險(xiǎn)(G3)患者的間質(zhì)型CTCs陽性率及CTCs總數(shù)≥3的患者比例明顯高于中風(fēng)險(xiǎn)(G2)患者。2、CTCs的總數(shù)及間質(zhì)型CTCs的個(gè)數(shù)能夠在一定程度上預(yù)測(cè)膀胱癌的惡性程度。3、CTCs的陽性檢出率與膀胱癌的TNM分期、淋巴結(jié)轉(zhuǎn)移、近期生存率之間未發(fā)現(xiàn)明顯相關(guān)性。
[Abstract]:[objective] to detect the count and typing of circulating tumor cells (CTCs) in peripheral blood of patients with non muscle-invasive bladder cancer NMIBCs and those with muscle-invasive bladder cancer MIBCs.To evaluate its clinical value in TNM staging and prognosis evaluation of bladder cancer.[methods] 41 patients with bladder tumor who underwent laparoscopic radical cystectomy or transurethral resection of bladder tumor in urology department of the second affiliated Hospital of Kunming Medical University were examined by CanPatrolTM second-generation CTCs.CTCs in peripheral blood were detected.The patients were 33-83 years old, 37 male and 4 female.The TNM staging of the tumor was as follows: 15 cases of T 1 stage, 12 cases of T 2 stage, 9 cases of T 3 stage, 5 cases of T 4 stage, 6 cases of N 1 stage and 3 cases of M 1 stage.The pathological grade of the tumor was 30 cases of high grade bladder cancer and 11 cases of low grade bladder cancer.[results] the total positive rate of CTCs in 41 cases of bladder cancer was 68.29% and 28% / 41% respectively. Of the 6 cases of lymph node metastasis, 2 cases were positive for CTCs in 2 cases and 3 cases were detected for distant metastasis. 1 case was positive for CTCs in 30 cases of high grade bladder cancer, 20 cases were positive for CTCs.Of the 11 cases of low grade bladder cancer, 7 cases were detected by CTCs, accounting for 63.6%. Of the 13 cases with negative CTCs, 10 cases had no lymph node metastasis and 69.23% had no lymph node metastasis, and 3 cases had lymph node metastasis.The positive rate of interstitial type CTCs in patients with non-invasive bladder cancer with high risk of G3 was 60%. The positive rate of G2 in patients with non-invasive bladder cancer was 0. 60%, and that in patients with non invasive bladder cancer was higher than 3, and that in non invasive bladder cancer patients with high risk of G2) was higher than that in non myometrial invasive bladder cancer.The positive rate of interstitial CTCs was 3 in the total number of 20 and 20. 29 patients were followed up from 12 to 41 months after operation, with an average of 14 鹵2 months and 8 dead cases.The overall survival rate was 72.41%, in which the positive survival rate of CTCs was 77.77% and the negative survival rate of 14% / 18% was 63.6% / 11%.[conclusion] 1. The positive rate of interstitial CTCs and the proportion of CTCs 鈮，

本文編號(hào)：1755132