Endoscopic Ultrasound-Guided Acquisition of Portal Venous Circulating Tumor Cells as a Potential Diagnostic and Prognostic Tool for Pancreatic Cancer.
Endoscopic Ultrasound-Guided Acquisition of Portal Venous Circulating Tumor Cells as a Potential Diagnostic and Prognostic Tool for Pancreatic Cancer.
复制标题
超声内镜引导下采集门静脉循环肿瘤细胞作为胰腺癌的潜在诊断和预后工具
DOI：
10.2147/cmar.s330473
复制
发表时间：
2021
影响因子：
3.3
通讯作者：
Lv Y
中科院分区：
文献类型：
--
作者：
Zhang Y;Su H;Wang H;Xu C;Zhou S;Zhao J;Shen S;Xu G;Wang L;Zou X;Zhang S;Lv Y
背景 循环肿瘤细胞 (CTC) 是一种很有前景的胰腺癌 (PC) 液体活检方法，但在外周血中循环的计数较低。我们评估了门静脉 (PoV) CTC 在 PC 患者中的诊断和预后价值。方法 在 EUS 引导下对 40 例疑似胰胆癌患者进行 PoV 抽吸。使用 EpCAM 和 Twist 抗体通过免疫荧光鉴定 CTC 的上皮-间质转化相关亚型。通过接受者操作特征 (AUC) 曲线和 Kaplan-Meier 生存分析研究 PoV CTC 的诊断和预后性能。结果 共纳入40例患者，其中PC 31例，非胰腺壶腹周围癌4例，良性胰腺疾病（BPD）5例。与外周血相比，PoV 中 CTC 的检测量更高。 BPD 患者中的 PoV CTC 数量低于 PC 患者。 PoV CTC，尤其是间充质 CTC（M-CTC）的数量与肿瘤负荷呈正相关，而不是上皮 CTC（E-CTC）。 PoV CTC 数字和 CA19-9 的组合在区分 PC 与 BPD 方面表现出比单独使用任何一种方法更好的诊断效率（AUC 值 0.987）。此外，PoV CTCs和M-CTCs在区分早期和晚期PC方面的诊断效能明显优于E-CTCs和CA19-9。最后，高 PoV CTC 和 M-CTC 数量均与较短的总生存期相关。结论 通过 EUS 引导程序采集 PC 患者 PoV 样本已被证明是安全可行的。 PoV CTC，尤其是 M-CTC，在诊断和预测 PC 预后方面具有巨大潜力，特别是与 CA19-9 联合使用。
Background Circulating tumor cells (CTCs) were a promising liquid biopsy for pancreatic cancer (PC) but circulate in low counts in peripheral blood. We evaluated the diagnostic and prognostic values of portal vein (PoV) CTCs in PC patients. Methods PoV was aspirated under EUS guidance from 40 patients with suspected pancreaticobiliary cancers. Epithelial–mesenchymal-transition-related subtypes of CTCs were identified via immunofluorescence using EpCAM and Twist antibodies. The diagnostic and prognostic performance of PoV CTCs was investigated by receiver-operating characteristic (AUC) curve and Kaplan–Meier survival analysis. Results In total, 40 patients including 31 with PC, 4 with non-pancreatic periampullary cancer and 5 with benign pancreatic diseases (BPD) were enrolled. CTCs were detected more in PoV compared with peripheral blood. PoV CTC numbers in BPD patients were lower than in PC patients. The number of PoV CTCs, especially mesenchymal-CTCs (M-CTCs), was positively correlated with the tumor burden, instead of epithelial-CTCs (E-CTCs). The combination of PoV CTC numbers and CA19-9 demonstrated better diagnostic efficiency (AUC value 0.987) than either alone in differentiating PC with BPD. Moreover, the diagnostic efficacy of PoV CTCs and M-CTCs were obviously better than that of E-CTCs and CA19-9 in distinguishing early and late stage PC. Lastly, high PoV CTC and M-CTC numbers were both associated with shorter overall survival. Conclusion Acquisition of the PoV samples in PC patients via EUS-guided procedures has been proved safe and feasible. PoV CTCs, especially M-CTCs, have great potentials in diagnosing and predicting the prognosis of PC, especially in combination with CA19-9.