本文選題：食管鱗癌 + CTCs�。� 參考：《中華腫瘤防治雜志》2017年08期

【摘要】：目的循環(huán)腫瘤細胞(circulating tumor cells,CTCs)被認(rèn)為是腫瘤復(fù)發(fā)轉(zhuǎn)移的重要因素之一,食管鱗癌患者放療后CTCs陽性率較治療前下降并和預(yù)后相關(guān)。本研究探討進展期食管鱗癌新輔助化療中CTCs的狀態(tài),以及CTCs與食管癌臨床特征及預(yù)后的相關(guān)性。方法回顧性分析十堰市太和醫(yī)院(湖北醫(yī)藥學(xué)院附屬醫(yī)院)2013-01-10-2014-03-27收治的96例食管鱗癌患者,采用免疫磁珠富集聯(lián)合免疫熒光法檢測患者外周血中CTCs,對比分析患者CTCs狀態(tài)與臨床特征及2年生存率的關(guān)系。同時分析患者新輔助放化療前后CTCs狀態(tài)的變化,以期明確新輔助治療的意義及適應(yīng)人群。計數(shù)資料采用χ~2檢驗或Fisher精確概率法,生存分析采用Kaplan-Meier法和Cox模型法。結(jié)果 96例患者隨訪至2016-03-27,隨訪率100%,中位隨訪時間25個月。患者CTCs狀態(tài)與腫瘤的病變長度、T分期、N分期及臨床分期相關(guān)(P0.05),與患者的年齡、性別及病變部位無關(guān),P0.05。首診CTCs陽性患者的中位生存時間約19.2個月;而CTCs陰性患者的中位生存時間約26.8個月,兩者差異有統(tǒng)計學(xué)意義,P=0.038。Cox模型結(jié)果顯示,Ⅲ~ⅣA期是影響CTCs不同狀態(tài)患者的獨立危險因素。首診CTCs陽性的患者Ⅱ期中位生存時間為28.2個月,與CTCs陰性患者的30.2個月比較,差異無統(tǒng)計學(xué)意義,P=0.189;但Ⅲ期的中位生存時間分別為19.9和24.6個月,差異有統(tǒng)計學(xué)意義,P=0.044;ⅣA期的中位生存時間分別為11.2和21.2個月,差異有統(tǒng)計學(xué)意義,P=0.045。新輔助治療后,有21例(34.42%)患者由CTCs陽性轉(zhuǎn)為陰性,轉(zhuǎn)陰率差異有統(tǒng)計學(xué)意義,P=0.002。新輔助治療后,CTCs仍為陽性的患者中位生存時間約16.5個月,與CTCs轉(zhuǎn)陰的患者(23.4個月)和首診CTCs陰性的患者(26.8個月)比較,差異有統(tǒng)計學(xué)意義,P0.05;但后兩者差異無統(tǒng)計學(xué)意義,P0.05。結(jié)論 CTCs可反映食管癌患者的疾病進展程度,并可作為判斷預(yù)后的指標(biāo)。此外,新輔助放化療可改善首診CTCs陽性患者的中位生存時間。
[Abstract]:Objective circulating tumor cells were considered to be one of the important factors of tumor recurrence and metastasis. The positive rate of CTCs in patients with esophageal squamous cell carcinoma after radiotherapy was lower than that before radiotherapy and was related to prognosis. This study was to investigate the status of CTCs in neoadjuvant chemotherapy for advanced esophageal squamous cell carcinoma and the correlation between CTCs and clinical features and prognosis of esophageal carcinoma. Methods 96 patients with esophageal squamous cell carcinoma treated in Taihe Hospital of Shiyan City (affiliated Hospital of Hubei Medical College) were retrospectively analyzed. CTCs in peripheral blood of patients were detected by immunomagnetic bead enrichment combined with immunofluorescence. The relationship between CTCs status and clinical features and 2 year survival rate was compared and analyzed. The changes of CTCs status before and after neoadjuvant radiotherapy and chemotherapy were analyzed in order to determine the significance of neoadjuvant therapy and adapt to population. The count data were analyzed by 蠂 ~ 2 test or Fisher exact probability method, and survival analysis by Kaplan-Meier method and Cox model method. Results 96 patients were followed up to 2016-03-27, the follow-up rate was 100 and the median follow-up time was 25 months. The CTCs status was correlated with the length of the tumor, T stage and clinical stage (P 0.05), but not with the age, sex and location of the tumor. The median survival time of first diagnosed CTCs positive patients was 19.2 months, while that of CTCs negative patients was 26.8 months. The difference was statistically significant. Stage 鈪，

本文編號：1839550