Postoperative Detection of Circulating Tumor Cells Predicts Tumor Recurrence in Colorectal Cancer Patients
Postoperative Detection of Circulating Tumor Cells Predicts Tumor Recurrence in Colorectal Cancer Patients
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DOI：
10.1007/s11605-013-2258-6
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发表时间：
2013-10-01
影响因子：
3.2
通讯作者：
Lieto, Eva
中科院分区：
文献类型：
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作者：
Galizia, Gennaro;Gemei, Marica;Lieto, Eva
循环肿瘤细胞被认为在远处转移的发展中起着至关重要的作用。在结直肠癌患者的血液中检测到它们可能与预后不良有关，但目前的证据是有争议的。在76例接受手术切除的结直肠癌患者中进行了术前和术后血液样本的流式细胞术分析。EpCAM/CD 326上皮表面抗原用于鉴定循环肿瘤细胞。54例（71%）患者术前显示循环肿瘤细胞，所有转移患者均显示高水平的循环肿瘤细胞。手术切除导致循环肿瘤细胞水平显著降低。在69例接受根治性手术的患者中，16例术后循环肿瘤细胞水平较高，12例（75%）出现肿瘤复发。术后高水平的循环肿瘤细胞是与癌症复发相关的唯一独立变量。在没有循环肿瘤细胞的患者中，无进展生存率从16%增加到86%，肿瘤复发的风险降低超过90%。术后高水平的循环肿瘤细胞准确预测肿瘤复发，这表明循环肿瘤细胞的评估可以优化结直肠癌患者的定制管理。
Circulating tumor cells are thought to play a crucial role in the development of distant metastases. Their detection in the blood of colorectal cancer patients may be linked to poor outcome, but current evidence is controversial.Pre- and postoperative flow cytometric analysis of blood samples was carried out in 76 colorectal cancer patients undergoing surgical resection. The EpCAM/CD326 epithelial surface antigen was used to identify circulating tumor cells.Fifty-four (71 %) patients showed circulating tumor cells preoperatively, and all metastatic patients showed high levels of circulating tumor cells. Surgical resection resulted in a significant decrease in the levels of circulating tumor cells. Among 69 patients undergoing radical surgery, 16 had high postoperative levels of circulating tumor cells, and 12 (75 %) experienced tumor recurrence. High postoperative level of circulating tumor cells was the only independent variable related to cancer relapse. In patients without circulating tumor cells, the progression-free survival rate increased from 16 to 86 %, with a reduction in the risk of tumor relapse greater than 90 %.High postoperative levels of circulating tumor cells accurately predicted tumor recurrence, suggesting that assessment of circulating tumor cells could optimize tailored management of colorectal cancer patients.