摘要
目的探讨外周血CTCs与前列腺癌临床特征的相关性,及其在前列腺癌筛查、监测中的应用价值。方法回顾性分析2016年1月至2018年12月期间昆明市延安医院泌尿外科收治的110例前列腺疾病(前列腺增生或前列腺癌)患者的临床资料。按诊断不同分为两组,其中57例前列腺癌患者作为研究组,53例前列腺增生患者作为对照组。利用免疫磁球分离及荧光染色法对外周血中的CTC进行计数。统计并分析研究组与对照组CTCs阳性率的差异。根据CTCs计数结果,将研究组57例进一步分为CTCs阳性组和CTCs阴性组,对比2组PSA、Gleason评分、病理分期≥T3a发生率、骨转移发生率等指标的差异。CTCs阳性标准:外周血中CTCs≥5个/3.75 mL。结果研究组CTCs平均数量(7.4±1.5)个显著高于对照组(2.1±0.9)个,差异具有统计学意义(t=22.2616,P<0.0001)。研究组CTCs阳性率61.4%(35/57)显著高于对照组5.7%(3/53),差异具有统计学意义(χ^2=35.3157,P<0.0001)。CTCs阳性组患者PSA值[(35.4±15.7)ng/mL与(17.5±10.6)ng/mL]、Gleason评分[(8.1±1.3)与(7.2±1.1)]和骨转移发生率[34.3%(12/35)与9.1%(2/22)]均显著高于CTCs阴性组,差异具有统计学意义(P<0.05)。CTCs阳性组的病理分期≥T3a发生率[29.2%(7/24)与30.3%(10/33)]大于CTCs阴性组,但差异不具有显著性(P>0.05)。结论CTCs与前列腺癌的发病风险呈正相关性,CTCs阳性与前列腺癌PSA值、Gleason评分和骨转移发生率有明显相关性,CTCs检测可作为一项辅助诊断技术应用于前列腺癌的筛查和病情监测、预后风险评估,具有较好的潜在临床应用价值。
Objective To investigate the correlation between circulating tumor cells(CTCs)in peripheral blood and clinical features of prostate cancer,and its application value in prostate cancer screening and monitoring.Methods The clinical data of 110 patients with prostate disease(prostatic hyperplasia or prostate cancer)admitted to our department from January 2016 to December 2018 were retrospectively analyzed.According to the different of diagnosis,the patients were divided into two groups,57 patients with prostate cancer as the study group and 53 patients with benign prostatic hyperplasia as the control group.CTCs in peripheral blood was counted by immunomagnetic sphere separation and fluorescence staining.The difference in the positive rate of CTCs between the study group and the control group was analyzed.According to the results of CTCs detection,57 patients in the study group were further divided into CTCs-positive group and CTCs-negative group.The differences in PSA,Gleason score,incidence of pathological stage≥T3a,and bone metastasis rate were compared between the two groups.Criteria forCTCs positive:CTCs in peripheral blood≥5/3.75 mL.Results The average number of CTCs in the study group[(7.4±1.5)]was significantly higher than that in the control group[(2.1±0.9)](t=22.2616,P<0.0001).The positive rate of CTCs in the study group was61.4%(35/57),which was significantly higher than that in the control group 5.7%(3/53)(χ^2=35.3157,P<0.0001).The PSA(35.4±15.7)ng/mL vs(17.5±10.6)ng/mL,Gleason score(8.1±1.3)vs.(7.2±1.1)and bone metastases rate 34.3%(12/35)vs 9.1%(2/22)in the CTCs-positive group was significantly higher than that in the CTCs-negative group(P<0.05).The incidence of pathological stage≥T3a in the CTCs-positive group 29.2%(7/24)vs 30.3%(10/33)was higher than that in the CTCs-negative group,but the difference was not statistically significant(P>0.05).Conclusions There is a positive correlation between CTCs and the risk of prostate cancer.The positive CTCs was associated with the PSA,Gleason score and bone metastasis rate of prostate cancer.CTCs could be used as an auxiliary diagnostic technique for screening,monitoring and prognosis risk assessment of prostate cancer,It has good potential clinical application value.
作者
李珲
平秦榕
史云强
王春晖
杨洋
胡礼炳
毕晓方
李健
钟一鸣
LI Hui;PING Qin-rong;SHI Yun-qiang;WANG Chun-hui;YANG Yang;HU Li-bing;BI Xiao-fang;LI Jian;ZHONG Yi-ming(Dept.of Urology,Yan'an Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650051,China)
出处
《昆明医科大学学报》
CAS
2020年第1期52-56,共5页
Journal of Kunming Medical University
基金
国家自然科学基金资助项目(81960146)
云南省医疗卫生单位内设机构科研基金资助项目(2016NS316)
云南省科技惠民专项基金资助项目(2017RA017)
云南省卫生和计划生育委员会医学学科带头人基金资助项目(D-2017044)
云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(2018FE001-090)
云南省肿瘤免疫防治重点实验室开放课题(2017DG004-04)
昆明市卫生科技人才培养项目暨“十百千”工程培养计划基金资助项目(2018-sw(省)-04)
昆明市卫生健康委员会卫生科研基金资助项目(2019-14-02-004)。
关键词
前列腺癌
循环肿瘤细胞
外周血
免疫磁球分离
荧光染色
Prostate cancer
Circulating tumor cells
Peripheral blood
Immunomagnetic sphere separation
Fluorescent staining
作者简介
李珲(1964-),男,云南昆明人,医学学士,主任医师,主要从事泌尿系肿瘤的微创诊疗工作;通信作者:钟一鸣,E-mail:africanzhong@qq.com。
