摘要
目的检测肝癌患者外周血中循环肿瘤细胞(CTC),探讨CTC检测在肝癌诊断和治疗监测中的应用价值。方法选择肝癌患者27例纳入肝癌组,另选30例健康体检者为对照组。采集两组外周血,用差减富集技术富集CTC,荧光原位杂交技术选择CTC;采用电化学发光法检测两组血清肿瘤标志物甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)。比较CTC、AFP、CEA、CA199检测诊断肝癌的敏感性、特异性、约登指数。分析CTC检测结果与索拉菲尼靶向治疗效果的关系。结果肝癌组CTC阳性22例(81.5%),对照组均未检出CTC,两组检出率相比,P<0.05。肝癌患者中均检出C亚群肿瘤细胞,肝胆管细胞癌患者检出A、B、C亚群肿瘤细胞。所有CTC阳性患者外周血中均检出多倍体CTC,以三倍体肿瘤细胞数量最多(59.8%)。肝癌组中,AFP阳性17例、CEA阳性10例、CA199阳性11例,对照组分别为2、1、0例。CTC检测诊断肝癌的约登指数均高于三项肿瘤标志物检测(P均<0.05)。肝癌组中10例坚持服用索拉菲尼,8例治疗过程中CTC数量未有明显变化,疗效评价为SD,2例治疗前CTC总数较高患者(>15/7.5 m L)在索拉菲尼治疗1个周期后有明显下降(<5/7.5 m L),但疗效评价也为SD。结论利用差减富集技术可有效检出肝癌患者外周血中的CTC。CTC检测较常用肿瘤标志物检测在肝癌诊断方面更有优势,也有助于评估肝癌患者靶向治疗的效果。
Objective To observe the circulating tumor cells （CTC） in the peripheral blood of patients with liver cancer and to investigate the application of CTC detection in the early diagnosis and monitoring treatment of liver cancer .Methods Twenty-seven patients with primary liver cancer were selected as the liver cancer group and 30 healthy person were selected as the control group.The peripheral blood was collected, and we enriched the CTC by subtraction enrichment technology and identified them by fluorescence in situ hybridization （FISH） technique.The serum tumor markers AFP, carcino-embryonic antigen （CEA） and CA199 of the two groups were detected by electrochemiluminescence method .The sensitivity, specificity and youden index of CTC, AFP, CEA and CA199 were comprehensively compared, and the relationship between CTC and therapeutic effect of targe-ted therapy was analyzed.Results CTC was detected in 22 cases of the liver cancer group, while in the control group the num-ber was 0 （P〈0.05）.C subset of tumor cells was detected in 22 cases of the liver cancer group while there was only 1 case of A subset and 1 case of B subset.Polyploidy tumor cells were all detected in patients with positive CTC, and the triploid took the largest proportion （59.8%）.In the liver cancer group, 17 cases were positive AFP, 10 cases were positive CEA and 11 cases were positive CA199, while the numbers in the control group were respectively 2, 1 and 0.The youden index of CTC detection was better than the other three tumor markers in detection and diagnosis （P〈0.05）.Ten patients in the liver cancer group insis-ted taking target drugs, the number of CTC was stable in 8 patients, the RECIST was SD.The number of CTC declined （〈5/7.5 mL） in 2 patients with high TCT number （〉15/7.5 mL） after taking one-week Sorafenib, while the RECIST was also SD. Conclusions CTC in the peripheral blood of patients with liver cancer could be detected effectively by subtraction enrichment technique.Compared with common tumor markers, the CTC detection shows more advantages, and it could be used to assess the effect of targeted therapy in patients with liver cancer.
出处
《山东医药》
CAS
北大核心
2016年第19期19-21,共3页
Shandong Medical Journal
基金
首都临床特色应用研究项目(Z121107005112001)
国家高技术研究发展计划项目(2011AA02A111)
关键词
循环肿瘤细胞
肝肿瘤
肝癌
肿瘤标志物
circulating tumor cells
liver neoplasms
liver cancer
tumor biomakers
作者简介
马清（1990-），女，硕士研究生，主要研究方向为免疫学。E—mail：395050029@qq．com
通信作者简介：陈建魁（1963-），男，主任医师，主要研究方向为免疫学。E-mail：chenjk307@163．com
