摘要
目的 分析晚期食管癌化疗患者外周血循环肿瘤细胞(circulating tumor cells, CTC)动态变化与其预后的关系。方法 采用回顾性研究,选择2021年1月—2022年12月三门峡市中心医院收治的93例晚期食管癌化疗患者作为研究对象,检测患者化疗前、化疗中与化疗后外周血,比较不同时点患者外周血CTC数目,以化疗1个疗程为观察终点,统计患者化疗后预后情况,分析晚期食管癌化疗患者外周血CTC动态变化与其预后的关系,同时绘制受试者工作特征(receiver operating characteristic, ROC)曲线探究晚期食管癌化疗患者外周血CTC动态变化对其预后的预测价值。结果 研究期间退出研究1例,无法继续化疗3例,病死2例,最终研究样本量为87例,其中预后不良32例,占比36.78%(32/87)。化疗前、化疗中及化疗后,预后不良组外周血CTC数目为(9.69±4.69)个/mL、(5.66±4.65)个/mL、(4.34±2.70)个/mL,高于预后良好组的(5.93±4.57)个/mL、(3.47±3.35)个/mL、(2.62±1.59)个/mL,差异有统计学意义(P<0.05);预后不良组与预后良好组外周血CTC组内各时点数目比较,差异有统计学意义(P<0.05)。经过点二列相关性分析,不同时点外周血CTC数目与晚期食管癌化疗患者预后不良呈正相关关系(r=0.370、0.265、0.378,均P<0.05)。绘制ROC曲线结果显示,化疗前、化疗中期、化疗后外周血CTC数目预测晚期食管癌化疗患者预后不良的AUC分别为0.756、0.630、0.698,且化疗前预测的价值更高。结论 晚期食管癌患者外周血CTC动态变化与其预后相关,CTC数目高可能提示预后不良风险高,应引起临床重视。
Objective To analyze the relationship between the dynamic changes of peripheral blood circulating tumor cells(CTC)and prognosis in patients with advanced esophageal cancer undergoing chemotherapy.Methods A prospective study was conducted,selecting 93 advanced esophageal cancer chemotherapy patients admitted to the hospital from January 2021 to December 2022 as the study subjects.The expression and number of CTC in peripheral blood of patients before,during and after chemotherapy were detected,and the expression and number of CTC in peripheral blood of patients at different time points were compared.One course of chemotherapy was taken as the end point of observation,and the prognosis of patients after chemotherapy was counted.The relationship between the dynamic changes of CTC in peripheral blood of patients with advanced esophageal cancer chemotherapy and their prognosis was analyzed.At the same time,the receiver operating characteristic(ROC)curve was drawn to explore the predictive value of dynamic changes of peripheral blood CTC in patients with advanced esophageal cancer chemotherapy on their prognosis.Results During the study period,1 case withdrew from the study,3 cases were unable to continue chemotherapy,and 2 cases died. The final study sample size was 87 cases, of which 32 cases had poor prognosis, accounting for 36. 78%(32/87). Before, during, and after chemotherapy, the number of peripheral blood CTCs in the poor prognosis groupwas (9. 69 ±4. 69) / mL, (5. 66 ±4. 65) / mL, and (4. 34 ±2. 70) / mL, which was higher than that in the good prognosis group (5. 93 ± 4. 57) / mL, (3. 47 ± 3. 35) / mL, and (2. 62 ± 1. 59) / mL, with a statistical significant difference(P <0. 05). There was a statistical significant difference in the number of points in the peripheral blood CTC group ateach time point between the poor prognosis group and the good prognosis group (P <0. 05). After point two column correlation analysis, there was a positive correlation between the number of peripheral blood CTCs at different time pointsand poor prognosis in patients with advanced esophageal cancer undergoing chemotherapy (r = 0. 370, 0. 265, 0. 378,all P <0. 05). The results of the ROC curve showed that the AUC of the number of peripheral blood CTCs before chemotherapy, during chemotherapy, and after chemotherapy to predict the poor prognosis of patients with advanced esophagealcancer chemotherapy was 0. 756,0. 630, and 0. 698, respectively, and the value of prediction before chemotherapy washigher. Conclusion The dynamic changes of peripheral blood CTC in patients with advanced esophageal cancer are related to their prognosis. The high number of CTC may indicate a high risk of poor prognosis and should be given clinicalattention.
作者
张向前
兰堃田
李伟明
ZHANG Xiang-qian;LAN Kun-tian;LI Wei-ming(Department of Oncology,Cancer Hospital,Sanmenxia Central Hospital,Sanmenxia,Henan 472000,China)
出处
《医药论坛杂志》
2024年第21期2261-2265,共5页
Journal of Medical Forum
基金
河南省医学科技攻关计划联合共建项目(LHGJ20210966)。
关键词
食管癌
晚期
化疗
外周血循环肿瘤细胞
预后
相关性
Esophageal cancer
Late stage
Chemotherapy
Peripheral blood circulating tumor cells
Prognosis
Relativity
