Prognostic value of pre- and post-operative circulating tumor cells detection in colorectal cancer patients treated with curative resection: a prospective cohort study based on ISET device.
Prognostic value of pre- and post-operative circulating tumor cells detection in colorectal cancer patients treated with curative resection: a prospective cohort study based on ISET device.
复制标题
结直肠癌根治性切除患者术前和术后循环肿瘤细胞检测的预后价值：基于ISET设备的前瞻性队列研究
DOI：
10.2147/cmar.s176575
复制
发表时间：
2018
影响因子：
3.3
通讯作者：
Xiong B
中科院分区：
文献类型：
--
作者：
Yang C;Shi D;Wang S;Wei C;Zhang C;Xiong B
背景循环肿瘤细胞(CTCs)被认为是一种很有前途的结直肠癌(CRC)生物标志物；然而，术后CTCs的预后价值仍不清楚。本研究旨在比较根治性切除治疗的结直肠癌患者手术前后CTCs对复发的预测价值。患者和方法确定2014年1月至2015年3月连续接受根治性切除的结直肠癌患者。手术前后分别用ISET仪CTCBIOPSY®计数外周血2.5mLCTCs。根据术前和术后的CTCS情况，纳入的患者分为四组：术前和术后CTCS−，术前CTCS−但术后CTCS+，术前CTCS+但术后CTCS−，以及术前和术后CTCS+。分析患者的3年无复发生存率(RFS)。结果共纳入138例患者，其中男性79例(57.2%)，中位年龄62[43-75]岁。术前CTCS+−患者的3年生存率(86.2%)比术前CTCS+组(67.0%)高19.2%(P=0.038)。术后CTCS+患者的3年生存率(57.1%)比合并CTCS+−患者(82.7%)低25.6%(P=0.001)。此外，术前术后CTCS阳性患者的3年−率(53.8%)比术前CTCS阳性但术后CTCS阳性患者(78.9%)低25.1%(P=0.004)。多因素分析显示，术后CTCS+(HR=2.82，95%CI=1.39~5.75，P=0.004)与3年无瘤生存率独立相关，而与术前CTCS+(HR=2.17，95%CI=0.75~6.31，P=0.153)无关。结论结直肠癌根治性切除患者术后CTCS+是预后不良的独立指标，而术前CTCS+不是独立指标。术后CTCS阳性的患者比术前CTCS阳性的患者复发风险更高。有必要进行术后评估，而不是术前评估。
Background Circulating tumor cells (CTCs) have been regarded as a promising biomarker for colorectal cancer (CRC); however, the prognostic value of post-operative (op) CTCs is still unclear. This study aimed to compare the recurrence prediction value of pre- and post-op CTCs in CRC patients treated with curative resection. Patients and methods Consecutive CRC patients treated with curative resection from January 2014 to March 2015 were identified. CTCs from 2.5 mL peripheral blood were enumerated with an ISETdevice-CTCBIOPSY® before and after surgery. Based on the status of pre- and post-op CTCs, the included patients were grouped into four cohorts: pre- and post-op CTCs−, pre-op CTCs− but post-op CTCs+, pre-op CTCs+ but post-op CTCs−, and pre- and post-op CTCs+. The 3-year recurrence-free survival (RFS) rate of patients was analyzed. Results A total of 138 patients (79 [57.2%] male; median age=62 [43–75] years) were enrolled. Patients with pre-op CTCs− had a 19.2% higher 3-year RFS rate (86.2%) than the combined cohorts with pre-op CTCs+ (67.0%) (P=0.038). Patients with post-op CTCs+ had aa 25.6% lower 3-year RFS rate (57.1%) than the combined cohorts with post-op CTCs− (82.7%) (P=0.001). Moreover, patients with pre- and post-op CTCs+ had a 25.1% lower 3-year RFS rate (53.8%) than patients with pre-op CTCs+ but post-op CTCs− (78.9%) (P=0.004). Multivariate analyses confirmed that post-op CTCs+ (HR=2.82, 95% CI=1.39–5.75, P=0.004), but not but pre-op CTCs+ (HR=2.17, 95% CI=0.75–6.31, P=0.153), was independently associated with shorter 3-year RFS rate. Conclusion Post-op CTCs+, but not pre-op CTCs+, is an independent indicator of poor prognosis for CRC patients treated with curative resection. Patients with post-op CTCs+ have a higher risk of recurrence those with pre-op CTCs+. Evaluation of post-op, rather than pre-op, CTCs is warranted.