Significance of circulating tumor cells in osteosarcoma patients treated by neoadjuvant chemotherapy and surgery.
Significance of circulating tumor cells in osteosarcoma patients treated by neoadjuvant chemotherapy and surgery.
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DOI：
10.2147/cmar.s176515
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发表时间：
2018
影响因子：
3.3
通讯作者：
Yuan ZC
中科院分区：
文献类型：
--
作者：
Wu ZJ;Tan JC;Qin X;Liu B;Yuan ZC
通过检测和鉴定骨肉瘤患者外周血循环肿瘤细胞（CTC）计数和亚型，评价CTC与骨肉瘤患者特征的关系，以及新辅助化疗和手术后CTC的变化。采用CanPatrol™ CTC技术检测32例骨肉瘤患者治疗前后外周血中的CTC。包括来自10名健康志愿者的外周血样品作为对照，并检查CTC的存在。在32例骨肉瘤患者中，30例患者在治疗前检测到CTC，平均CTC计数为14.06±9.08。在10名健康志愿者中未检测到CTC。将检测到的CTC分为上皮CTC、间充质CTC（M-CTC）和生物表型上皮/间充质CTC。III期患者治疗前CTC的平均数量高于IIB期患者（P=0.012）。在新辅助化疗后1周和手术后4周对28例患者进行了CTC计数变化筛查。我们根据治疗前后M-CTC百分比的变化将这28例患者分为两组，结果显示M-CTC增加组的无病生存期（DFS）明显短于M-CTC减少组或无变化组（P=0.032）。五名II期骨肉瘤患者在出现肺转移时进行了CTCs检查，发现这些患者出现肺转移时的CTCs总数高于治疗前。骨肉瘤患者外周血中CTC的存在率较高，治疗后M-CTC百分比增加的患者DFS较短。动态监测治疗后CTC计数的变化对及时发现复发或转移具有临床意义。
By examining and identifying circulating tumor cell (CTC) counts and subtypes of peripheral blood in osteosarcoma patients, we evaluated the relationship between CTCs and characteristics of osteosarcoma patients, as well as CTC changes after neoadjuvant chemotherapy and surgery. CanPatrol™ CTC technology was used to detect CTCs in peripheral blood before and after treatment in 32 osteosarcoma patients. Peripheral blood samples from 10 healthy volunteers were included as controls and examined for the presence of CTCs. Of the 32 osteosarcoma patients, CTCs were detected in 30 patients before treatment, and the average CTC count was 14.06±9.08. No CTCs were detected in the 10 healthy volunteers. The detected CTCs were divided into epithelial CTCs, mesenchymal CTCs (M-CTCs), and biophenotypic epithelial/mesenchymal CTCs. The average number of pretreatment CTCs was higher in stage III patients than in stage IIB patients (P=0.012). Twenty-eight patients were screened for changes in CTC count at 1 week after neoadjuvant chemotherapy and at 4 weeks after surgery. We divided these 28 patients into two groups according to the changes in the percentage of M-CTCs before and after treatment, and the results showed that the disease-free survival (DFS) was significantly shorter in the M-CTC percentage-increased group than in the M-CTC percentage-decreased or no-change group (P=0.032). Five patients with stage II osteosarcoma were examined for CTCs at the appearance of lung metastases, and the total number of CTCs was found to be higher at the appearance of lung metastases than before treatment in these patients. The rate of presence of CTCs in the peripheral blood of osteosarcoma patients is high, and patients with an increased percentage of M-CTCs after treatment have a shorter DFS. The dynamic monitoring of changes in CTC counts after treatment has clinical significance for the timely detection of recurrence or metastasis.