Dynamic monitoring of circulating tumour cells to evaluate therapeutic efficacy in advanced gastric cancer
Dynamic monitoring of circulating tumour cells to evaluate therapeutic efficacy in advanced gastric cancer
复制标题
动态监测循环肿瘤细胞评估晚期胃癌的治疗效果
DOI：
10.1038/bjc.2015.417
复制
发表时间：
2016-01-19
影响因子：
8.8
通讯作者：
Shen, Lin
中科院分区：
文献类型：
--
作者：
Li, Yilin;Gong, Jifang;Shen, Lin
背景：本研究旨在确定循环肿瘤细胞（CTC）在晚期胃癌（AGC）患者中的临床意义，特别是 CTC 在动态监测治疗反应中的潜在作用。方法：对 136 例新诊断 AGC 患者进行单中心前瞻性研究。使用 CellSearch 在基线和第一次反应评估时对患者的 CTC 进行计数。在临床状况允许纵向研究的15例患者中，对治疗期间的CTC进行纵向计数。结果：化疗6周后，不良的治疗后CTC水平（⩾ 3 CTC/7.5 ml）与客观缓解率（P = 0.016）和疾病控制率（P = 0.013）密切相关，并且还独立预测较短的无进展生存期和总生存期。特别是，治疗后转变为有利的 CTC 水平改善了预后，但转变为不利的 CTC 水平的患者的情况明显更差。治疗期间CTC升高可能与不良预后相关。结论：治疗后CTC水平可能有助于评估AGC患者的治疗反应并预测其预后。此外，治疗后 CTC 的变化可能有助于快速识别无效治疗和不良预后。
Background:This study was intended to determine the clinical significance of circulating tumour cells (CTCs) in patients with advanced gastric cancer (AGC), particularly the potential role of CTCs for dynamic monitoring of the therapeutic response.Methods:A single-centre, prospective study was undertaken in 136 patients with newly diagnosed AGC. The patients’ CTCs were enumerated using CellSearch at baseline and at the first response evaluation. In 15 patients whose clinical condition permitted longitudinal study, CTCs were longitudinally enumerated during treatment.Results:Following 6 weeks of chemotherapy, an unfavourable post-therapy CTC level (⩾ 3 CTCs per 7.5 ml) was closely correlated with the objective response rate (P= 0.016) and the disease control rate (P= 0.013), and it also independently predicted a shorter progression-free survival and overall survival. Particularly, conversion to a favourable CTC level following therapy improved the prognosis, but patients who changed to an unfavourable CTC level fared significantly worse. Elevated CTCs during therapy may be associated with a poor prognosis.Conclusions:Post-therapy CTC level may help in evaluating therapeutic response in patients with AGC and predicting their prognosis. In addition, changes in CTCs following therapy may be useful in rapidly identifying ineffective treatments and poor prognosis.