论文部分内容阅读
目的探讨卵巢癌患者外周血循环肿瘤细胞(circulating tumor cells,CTC)的水平及其与临床病理特征的关系。方法收集2012年1月至2013年12月确诊的卵巢癌患者40例,均行手术切除,所有患者经病理组织学证实为卵巢上皮来源恶性肿瘤。同时收集22例良性卵巢上皮囊肿组织作为对照组。空腹时抽取静脉血5 ml,4 h内采用优化的Can Patrol CTC富集技术检测血液中的CTC,并分析其与临床特征之间的关系。结果对照组均未检测出外周血CTC;卵巢癌组外周血CTC阳性率为77.5%,荧光显微镜下(×100)观察CTC计数(个数/视野):上皮型CTC为3.72±4.18,混合型CTC为6.94±8.72,间质型CTC为3.56±3.31。不同年龄、临床分期的卵巢癌患者所有类型外周血CTC水平差异均无统计学意义(P均>0.05);高分化和中分化患者外周血CTC无差异(P>0.05),与高分化和中分化患者比较,低分化患者混合型、间质型CTC水平明显增高(P<0.05);上皮型和混合型CTC区域淋巴结转移无明显差异(P>0.05),区域淋巴结转移阳性的患者间质型CTC水平较区域淋巴结阴性患者显著增多(P<0.05)。生存期分析提示,不同CTC水平的上皮型、混合型CTC组的无进展生存期差异无统计学意义(P>0.05),低间质型CTC组无进展生存期长于高间质型CTC组(P<0.05)。结论卵巢癌患者外周血中CTC水平较高,并且与细胞低分化、转移、复发等不良预后因素相关,可以作为评估病情的指标之一。
Objective To investigate the level of circulating tumor cells (CTCs) in peripheral blood of ovarian cancer patients and its relationship with clinicopathological features. Methods Forty ovarian cancer patients diagnosed from January 2012 to December 2013 were collected. All patients underwent surgical resection. All patients were confirmed by histopathology as ovarian epithelial malignant tumors. At the same time, 22 cases of benign ovarian epithelial cyst tissues were collected as the control group. Venous blood was drawn 5 ml on fasting, and blood CTCs were assayed within 4 h using optimized Can Patrol CTC enrichment technique and analyzed for its relationship to clinical features. Results No CTC was detected in the control group. The positive rate of CTC in peripheral blood of ovarian cancer group was 77.5%. The CTC count (number / field) under fluorescence microscope (× 100) was 3.72 ± 4.18 for epithelial CTC, CTC was 6.94 ± 8.72, and interstitial CTC was 3.56 ± 3.31. There was no significant difference in CTC levels in all types of ovarian cancer patients of different ages and clinical stages (all P> 0.05). There was no significant difference in CTCs between the well-differentiated and moderately differentiated patients (P> 0.05) In differentiated patients, mixed and interstitial CTC levels were significantly higher in poorly differentiated patients (P <0.05). There was no significant difference in epithelial and mixed CTC lymph node metastasis (P> 0.05), interstitial mesenchyme in patients with positive lymph node metastasis CTC levels were significantly higher than those with negative lymph nodes (P <0.05). Survival analysis showed that there was no significant difference in progression-free survival between epithelial and mixed CTC groups at different levels of CTC (P> 0.05), and the progression-free survival of low-quality CTC group was longer than that of high-quality CTC group P <0.05). Conclusion The level of CTC in peripheral blood of patients with ovarian cancer is high, and it is related to the poor prognosis factors such as poor differentiation, metastasis and recurrence of cells, which can be used as one of the indexes to evaluate the disease.